Radiology, Vol 189, 77-81, Copyright © 1993 by Radiological Society of North America
Value of maternal serum alpha-fetoprotein levels of 5.0 MOM or greater and prenatal sonography in predicting fetal outcome
JM Larson, DH Pretorius, NE Budorick and AL Scioscia
Department of Radiology, University of California, San Diego Medical Center.
PURPOSE: To determine fetal outcomes and the capability of sonography to
help predict these outcomes in patients with maternal serum alpha-
fetoprotein (MSAFP) levels of 5.0 multiples of the median or greater.
MATERIALS AND METHODS: Real-time sonography was performed in patients with
singleton and multiple gestations. After sonography, the pregnancy was
monitored. RESULTS: Inaccurate historical dating caused elevated MSAFP
levels in 14 patients. In the remaining 72 singleton gestations, 42 fetuses
(58%) had anomalies, 13 (18%) died in utero or after birth, three (4%) had
intrauterine growth retardation or were premature, and 14 (19%) were
normal, with no complications. A poor outcome occurred in 58 (80%) of the
singleton pregnancies, and sonography depicted an abnormality in 49 (84%)
of these patients. CONCLUSION: Most pregnant patients with MSAFP levels of
5.0 MOM or greater have an unfavorable outcome. Sonography depicts most of
these abnormal pregnancies.
