VALUE OF MATERNAL SERUM ALPHA-FETOPROTEIN LEVELS OF 5.0 MOM OR GREATER AND PRENATAL SONOGRAPHY IN PREDICTING FETAL-OUTCOME

PURPOSE: To determine fetal outcomes and the capability of sonography to help predict these outcomes in patients with maternal serum alpha-f etoprotein (MSAFP) levels of 5.0 multiples of the median or greater. M ATERIALS AND METHODS: Real-time sonography was performed in patients w ith singleton and multiple gestations. After sonography, the pregnancy was monitored.RESULTS: Inaccurate historical dating caused elevated M SAFP levels in 14 patients. In the remaining 72 singleton gestations, 42 fetuses (58%) had anomalies, 13 (18%) died in utero or after birth, three (4%) had intrauterine growth retardation or were premature, and 14 (19%) were normal, with no complications. A poor outcome occurred in 58 (80%) of the singleton pregnancies, and sonography depicted an a bnormality in 49 (84%) of these patients. CONCLUSION: Most pregnant pa tients with MSAFP levels of 5.0 MOM or greater have an unfavorable out come. Sonography depicts most of these abnormal pregnancies.