Maternal serum alpha fetoprotein

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Maternal serum alpha fetoprotein (MSAFP) is a screening test that examines the level of alpha fetoprotein (AFP) in a pregnant woman. AFP is produced by both the yolk sac and foetal liver during pregnancy.

Indications

Ideally, all pregnant women should undergo the screening test between 15-20 weeks gestation. The test is, however, recommended in:

  • advanced maternal age
  • previous births or pregnancy with chromosomal or congenital birth defects
  • family history of chromosomal or congenital birth defects
  • maternal diabetes

Clinical significance

MSAFP is often part of the triple (AFP, Estriol, and human chorionic gonadotropin) or quadruple screening tests (AFP, estriol, human chorionic gonadotropin and Inhibin A) for congenital birth defects.

Elevated MSAFP can be seen in: