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Maternal serum-alpha-fetoprotein (MSAFP)

What is alpha fetoprotein?

Alpha fetoprotein (AFP) is a protein substance produced by the liver of the foetus, and binds the hormone, estradiol.

A small amount of this protein is excreted from the kidney of the foetus into the amniotic fluid, and then passes from the amniotic fluid into the mother's bloodstream.

The concentration of AFP in the mother's blood rises gradually into late pregnancy and can be easily measured by a blood test called the maternal-serum-alpha-fetoprotein test, or MSAFP. So, remember that there is always a certain amount in the mother's blood in normal pregnancies.

When is testing done?

The MSAFP is a routine screening blood test if certain foetal disorders are suspected. It is generally offered to women between the 15th and 20th week of pregnancy, and is most accurate when performed between 15 and 18 weeks' gestation.

What does this test screen for?

Abnormal MSAFP levels are associated with some genetic conditions, such as Down's syndrome, and certain birth defects such as spina bifida or intestinal strictures, growth retardation and some late-pregnancy complications.

As fetal genetic disorders are more common in women aged over 35, MSAFP is typically offered to pregnant women over this age, and to those with a relevant family medical history. Certain defects, on the other hand, such as those causing abnormalities within the developing brain/spinal cord, can occur in previously unaffected families.

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