Second-trimester maternal serum alpha-fetoprotein (MSAFP) is elevated in women with adverse pregnancy outcome associated with inherited thrombophilias

Obstetric complications, such as severe pre-eclampsia, fetal growth restric tion, abruptio placentae, or stillbirth are associated with abnormally elev ated second-trimester maternal serum alpha-fetoprotein (MSAFP) and beta sub unit of human chorionic gonadotrophin (beta hCG). This has been attributed to placental abnormalities. Women with thrombophilias have been shown to ha ve abnormalities of the placenta resulting in adverse pregnancy outcome in these patients. The purpose of the present study was to evaluate whether wo men with pregnancy complications and inherited thrombophilias have abnormal ly elevated second-trimester MSAFP or beta hCG. Sixty-two women with pregna ncy complications were tested for inherited thrombophilias several months a fter delivery. The thrombophilia group included 29 women with pregnancy com plications and an inherited thrombophilia and the control group included 33 other patients without thrombophilia. Patients in the thrombophilia group had a higher median MoM MSAFP compared to the controls (1.337 vs 1.086, p=0 .0516). The incidence of abnormally elevated MSAFP (>2.5 MoM) was also sign ificantly higher in the thrombophilia group compared to controls (21% vs 3% , p=0.04). Neither the median MoM beta hCG nor the incidence of abnormally elevated beta hCG were significantly different between the groups. We concl ude that second trimester MSAFP, but not beta hCG, is abnormally elevated i n patients with thrombophilia and obstetric complications. Copyright (C) 20 01 John Wiley & Sons, Ltd.