An elevation in the maternal serum alpha-fetoprotein (MSAFP) level during pregnancy has been shown to increase the risk of pregnancy complications (i.e., intrauterine growth retardation, premature labor or delivery, preeclampsia, fetal demise, etc.) and fetal structural anomalies. Ultrasound has been shown to be a useful tool in the identification and subsequent management of patients affected by these complications. At our facility, we routinely evaluate patients after one test reveals an elevated MSAFP level. Our findings support the concept of performing the ultrasonographic evaluation after the first finding of elevated MSAFP, and of using an MSAFP cutoff of >2.0 multiples of the median (MOM), rather than >2.5 MOM.
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