Marián Križko ml., Martin Gábor, Peter Papcun, Mikuláš Redecha
Detection of alpha-fetoprotein concentrations in the maternal serum is important additional information for the USG screening in gravidity, namely in searching for defects of the neural tube, front abdominal wall, in early diagnostics of teratomata, obstructions of the gastrointestinal tract and kidney pathology. With the increased level of alpha-fetoprotein in the maternal serum over 2,5-multiple of the median, the risk of structural deviation is increasing in the foetus. In the exclusion of the positivity of higher alpha-fetoprotein concentrations in the maternal serum and structural deviations in the foetus via USG examination, the detection of values in amniotic fluid comes into consideration. But the specificity with the regard of the possible risk of amniocentesis is relatively low. In pregnant women with the alpha-fetoprotein concentration in the maternal serum over 2,5 multiple of the median, without USG finding of the foetal structural deviations, the described occurrence of chromosome aberration in the foetus is approximately 1 % and twice higher compared to common population. In this group aberrations of sexual chromosomes are the most frequent. In the cases when neither the USG examination nor the examination of karyotype leads to explanation of high levels of AFP in the maternal serum, the adverse pregnancy development was observed with higher risk of premature labour, intrauterine foetal growth retardation, intrauterine death after 24 weeks of gestation, abnormal placentation, placental abruption and preeclampsia.