Alpha fetoprotein

How the Test is Performed

A blood sample is needed. For information on how this is done, see: Venipuncture

How to Prepare for the Test

There is no special preparation.

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

Your doctor may order this test to:

• Screen for problems in the baby during pregnancy
• Diagnose certain liver disorders
• Screen for and monitor some cancers

During pregnancy, this AFP test can be done along with amniocentesis to help detect spina bifida or other birth defects in the developing baby.

Normal Results

The normal values in males or nonpregnant females is generally less than 40 micrograms/liter.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Greater than normal levels of AFP may be due to:

• Cancer in testes, ovaries, biliary (liver secretion) tract, stomach, or pancreas
• Cirrhosis of the liver
• Liver cancer
• Malignant teratoma
• Recovery from hepatitis

During pregnancy, abnormal levels of AFP (as part of a quadruple screen) may be due to:

• Birth defects, including:
  • Anencephaly
  • Duodenal atresia
  • Gastroschisis
  • Omphalocele
  • Spina bifida
  • Tetralogy of Fallot
  • Turner syndrome
• Genetic disorders, including Down syndrome
• Inaccurate due date
• Intrauterine death (usually results in a miscarriage)
• Multiple pregnancy (twins, triplets, etc.)

Risks

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling lightheaded
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Alternative Names

Fetal alpha globulin; AFP

References

Simpson JL, Otaño L. Prenatal genetic diagnosis. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 7.

Lee P, Pincus MR, McPherson RA. Diagnosis and management of cancer using serologic tumor markers. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 74.

Cunningham FG, Leveno KJ, Bloom SL, et al. Prenatal diagnosis and fetal therapy. In: Cunningham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 13.

Update Date: 9/12/2011

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.