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 next best step?  

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23 years old, G1 P0, 18weeks pregnancy comes for antenatal care. MS-AFP levels are 3.5 MoM (high). Whats the next best step?

a) Repeat MS-AFP
c) Ultrasound
d) Genetic counseling



this is done through ultrasound.


c) Ultrasound - to confirm gestational age.

The MS AFP values are always taken relative to gestational age. If first reading shows a high or low MS-AFP then first step is to check for gestational age with an ultrasound (kaplan).
If levels are still high after confirming the dates, then get AF-AFP. If date discrepency is found, then repeat MS-AFP.


Thank you docdoc, those are very nice questions. GL!

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