Alpha-Fetoprotein (AFP) in Blood

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Test Overview
An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a substance made in
the liver of an unborn baby (fetus). The amount of AFP in the blood of a pregnant woman can help see whether the baby
may have such problems as spina bifida and anencephaly. An AFP test can also be done as part of a screening test to find
otherchromosomal problems, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18) . An AFP test can
help find an omphalocele, a congenital problem in which some of the baby's intestines stick out through the belly wall.
Normally, low levels of AFP can be found in the blood of a pregnant woman. No AFP (or only a very low level) is
generally found in the blood of healthy men or healthy, nonpregnant women.
The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15
and 20 weeks, these tests check the levels of three or four substances in a pregnant woman's blood. The triple screen
checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or
uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-
along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems
or birth defects.
Screening tests are used to see what the chance is that your baby has a certain birth defect. If a screening test is positive, it
means that your baby is more likely to have that birth defect and your doctor may want you to have a diagnostic test to
make sure.
Pregnancy: Should I Have Screening Tests for Birth Defects?
Men, nonpregnant women, and children
In men, nonpregnant women, and children, AFP in the blood can mean that certain types of cancer-especially cancer of
the testicles , ovaries , stomach,pancreas , or liver-are present. High levels of AFP may also be found inHodgkin's
disease , lymphoma , brain tumors, and renal cell cancer.
Why It Is Done
The AFP test is done to:
Check the developing baby (fetus) of a pregnant woman for brain or spinal problems (called neural tube defects ).
Such defects occur in about 2 out of every 1,000 pregnancies. footnote1 The chance of a neural tube defect in a baby is not
related to the mother's age. Most women whose babies have neural tube defects have no family history of these
problems.
Check the developing baby (fetus) of a pregnant woman for Down syndrome.
Find certain cancers, especially cancer of the testicles, ovaries, or liver. But up to half of the people with liver cancer
do not have high AFP levels.
Check how well treatment for cancer is working.
Check for liver cancer (called hepatoma) in people who have cirrhosis or chronic hepatitis B .

Results
An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a
substance made in the liver of a developing baby (fetus). The amount of AFP in the blood of a pregnant woman
can help find certain problems with her baby.
Normal
The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and
your lab may have a different range for what's normal. Your lab report should contain the range your lab uses.
Also, normal values vary with the age of the baby. A high or low AFP may mean that the age of the baby has
been recorded wrong or not calculated correctly. An ultrasound may be done to check the baby's age more
accurately.
 Alpha-fetoprotein in blood
Men and nonpregnant 0-40 nanograms per milliliter
women: (ng/mL) ormicrograms per liter (mcg/L) footnote2
Women 15-18 weeks 10-150 ng/mL or mcg/L footnote3
pregnant:
In pregnant women, the amount of AFP gradually rises starting in the 14th week of pregnancy. It continues to
rise until a month or two before giving birth, then it slowly decreases. Values are generally slightly higher for
black women than they are for white women. Values are slightly lower for Asian women than they are for white
women. An accurate estimate of the age of the baby is needed to understand the AFP value correctly.
The normal range of AFP values is adjusted for each woman's age, weight, and race; whether she
has diabetes that needs injections of insulin ; and the age of her baby (gestational age). If the age of the baby is
changed after an ultrasound, the AFP must then be adjusted as well. Each woman and her doctor need to look
at the range of AFP values that is normal for her when she has an AFP test.
High values
In a pregnant woman, high alpha-fetoprotein values can mean:
The age (gestational age) of the baby is wrong.
The woman is pregnant with more than one baby, such as twins or triplets.
The baby has a neural tube defect.
The baby's intestines or other abdominal organs are outside the body (called an abdominal wall defect or
omphalocele). Surgery after birth will be needed to correct the problem.
The baby is not alive.
In a nonpregnant adult, high alpha-fetoprotein values can mean:
Cancer of the liver, testicles, or ovaries is present.
Liver disease, such as cirrhosis or hepatitis , is present.
Alcohol abuse is present.
Low values
In a pregnant woman, a low level of alpha-fetoprotein can mean:
The age (gestational age) of the baby is wrong.
The baby may have Down syndrome .
In a nonpregnant adult, alpha-fetoprotein is not normally present.