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Q. My sister-in-law had an AFP done and it was abnormally high. She had a second one done and it was also abnormally high. She is very concerned. They are sure about her due date so that is not a question. What are her chances of having a child with a defect? She is going in for an ultrasound and amnio. Will this tell for sure about any problems?

Thanks for any input.

Janet

A. Janet,

The AFP test, or the triple screen, is just that a screening test, not an accurate diagnostic test.

These tests work by measuring certain levels of hormones in your body during the 15-17th weeks of pregnancy. Usually they are looking for alphafetoprotein, hCG, and estriadol.

We are finding that almost 40% of these tests come back with abnormal results, but less than 1% of the positive results ever have any problems.

Other reasons for the screwy results are, as you mention, inaccurate due dates, fetal anomalies such as down syndrome, anencephaly, spina bifida, multiple gestations, and a fair number of other causes.

While it's extremely nerve wrenching, remember these tests are not accurate for diagnosing and you must also remember that the other tests (amniocentesis) do have drawbacks, such as risk of miscarriage, water breaking, infection, etc.

Hang in there!

Cyndi Klausing, RN, ACCE, has been a childbirth educator and breastfeeding counselor for over 18 years. She currently works as a newborn nursery nurse and is the mother of four sons.

Cyndi will answer your questions on fertility, pregnancy, birth, breastfeeding and babies. Her advice does not take the place of your practitioner. Personal answers will not always be possible.