High Alpha-Fetoprotein Levels During Pregnancy: What You Need to Know

During pregnancy, elevated levels of Alpha-fetoprotein (AFP) may occur?

Hello Doctor, my wife is 18 weeks pregnant with twins.
During a company health check at 15 weeks, her AFP level was found to be elevated at 112 (normal range is 0-13.4), while her SGOT and SGPT levels were normal.
My wife has hepatitis B, so we are concerned that this might indicate liver issues.
Additionally, when we asked the obstetrician, he mentioned that elevated AFP levels during pregnancy can be normal.
Is this correct? The doctor recommended an abdominal ultrasound; what other tests would be advisable for safety? Thank you!

Johnson, 30~39 year old female. Ask Date: 2004/11/08

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! It is normal for pregnancy to cause an increase in fetal protein levels, as this is a typical phenomenon during pregnancy.
Moreover, the physician has tested GOT and GPT, and both are within the normal range, so there is no need to be overly concerned.
The doctor recommends an ultrasound, which is necessary.

Reply Date: 2004/11/08

More Info

High levels of Alpha-Fetoprotein (AFP) during pregnancy can be concerning, especially when they are significantly elevated, as in your wife's case. AFP is a protein produced by the fetal liver, and its levels can be measured in the mother's blood. While it is true that AFP levels can be higher during pregnancy, particularly in multiple gestations (like twins), an AFP level of 112 is notably above the normal range (0-13.4).
Elevated AFP levels can be associated with several conditions, including neural tube defects, abdominal wall defects, and certain chromosomal abnormalities. Additionally, since your wife has a history of hepatitis B, it is understandable to be concerned about potential liver issues. However, normal SGOT (AST) and SGPT (ALT) levels suggest that her liver function is currently stable, which is reassuring.
The recommendation from your obstetrician to perform an abdominal ultrasound is appropriate. This imaging study can help assess the fetal anatomy and check for any potential abnormalities that could explain the elevated AFP levels. It is also a good idea to discuss further testing options with your healthcare provider. These may include:
1. Detailed Ultrasound: This can provide a more comprehensive view of the fetal anatomy and help identify any structural anomalies.

2. Amniocentesis: If there are significant concerns based on ultrasound findings, this procedure can be performed to analyze the amniotic fluid for genetic abnormalities.

3. Maternal Serum Screening: Additional blood tests can be conducted to evaluate other markers that may indicate risk for chromosomal abnormalities.

4. Follow-up Blood Tests: Monitoring AFP levels over time can provide insight into whether the levels are stable, rising, or falling, which can help in assessing the situation.

It is essential to maintain open communication with your healthcare provider throughout this process. They can provide personalized recommendations based on your wife's specific situation and any findings from the ultrasound or additional tests.

In summary, while elevated AFP levels can be concerning, they are not always indicative of a serious problem, especially in the context of a multiple pregnancy. The combination of careful monitoring, appropriate imaging, and possibly further testing will help ensure that both your wife and the babies are healthy. Always consult with your healthcare provider for the most accurate advice tailored to your wife's health and pregnancy.

Similar Q&A

Understanding Elevated Fetal Protein Levels: What You Need to Know

My husband recently had a health check at his company, which revealed an elevated alpha-fetoprotein (AFP) level of 65. He then went to the Gastroenterology Department at Tri-Service General Hospital for further evaluation, where his AFP level was again found to be elevated (over ...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: The causes of elevated fetal protein levels include hepatitis, cirrhosis, liver cancer, or other tumors such as germ cell tumors and testicular inflammation, as well as pregnancy. Generally, if the fetal protein level exceeds 400, liver cancer should be suspected. In your ...

Elevated Alpha-Fetoprotein Levels: What Could It Mean for Your Health?

Hello, doctor. Last month during my company's health check-up, my alpha-fetoprotein (AFP) level was 13 (the hospital's normal range is below 10.9). My liver function tests were normal. Last week, I went for a follow-up, and my AFP level increased to 14. During the follo...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello: Fetal protein is a protein that appears in fetal serum and disappears after birth. The causes of elevated fetal protein levels include pregnancy, hepatitis, cirrhosis, liver cancer, germ cell tumors, testicular cancer, and other reproductive and urinary system tumors. For ...

Understanding Elevated Alpha-Fetoprotein Levels in Hepatitis B Patients

I started experiencing abnormal GPT levels between 30-40 (normal value 35 U/L) since June 2000, with fetal protein at 2.9 ng/ml (normal value 25 ng/ml). The e-antigen was negative; e-antibody was positive; core antibody was positive. However, on December 15, 2000, the fetal prote...

Dr. Yang Guojun reply Internal Medicine
As a carrier of hepatitis B, you only need to undergo ultrasound and tests for GOT, GPT, and AFP every 3 to 6 months (performed by a gastroenterologist), and you do not need to take medication at this time.

Understanding Abnormal Pregnancy Test Results: AFP and White Blood Cell Counts

Hello, Doctor. I had a health check-up when I was about thirteen weeks pregnant, and the report showed that my fetal protein AFP level is 18.91. Is this level normal? I believe the normal range is 0-7. Additionally, regarding my white blood cell count, my neutrophil percentage is...

Dr. Lin Wenbin reply Obstetrics and Gynecology
During pregnancy, the fetus produces alpha-fetoprotein (AFP), which will naturally result in higher levels compared to the non-pregnant range of 0-7. However, to determine if the AFP level is excessively high and assess the risk of Down syndrome, it is necessary to consider the s...