"...a high AFP is a warning sign for spina bifida - but it is also a warning sign for "adverse pregnancy outcome..."

Q:  Have there been any studies or is there a connection between a positive Triple AFP test and HELLP syndrome?  I developed HELLP and had to deliver my baby at 23 weeks.  Unfortunately, my baby did not survive. About 4-6 weeks before developing HELLP I was told by my doctor that I would be considered high risk because of a positive Triple AFP test and that I would need to repeat the test and have a level 2 sonogram.  I repeated the test which came out with the same results, however the level 2 sonogram showed that there were no signs of spina bifida.  The doctors did not seem to be concerned and said everything was normal.  Were the Triple AFP results a warning sign?

A:  YES - a high AFP is a warning sign for spina bifida - but it is also a warning sign for "adverse pregnancy outcome" including HELLP, preeclampsia, and IUGR.  It probably signals that the placenta has been injured.

Thomas Easterling, M.D.
University of Washington

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