A client is scheduled for an abdominal ultrasound in two weeks to assess fetal growth and development during pregnancy.

Which of these statements made by the client indicates that further teaching is needed?

A low level of AFP (<0.5 MoM) in a pregnant woman can indicate that the fetus has a chromosomal abnormality, such as Down syndrome or Edwards syndrome.

This is because these conditions affect the development of the fetal liver, which produces AFP.

Choice A is wrong because neural tube defects, such as spina bifida, are associated with high levels of AFP (>2.5 MoM) in the maternal blood.

This is because AFP can leak from the open spinal canal of the fetus into the amniotic fluid and then into the maternal blood.

Choice C is wrong because maternal weight-related factors do not affect the level of AFP in the maternal blood.

However, they can affect the interpretation of the AFP test results, as the test needs to be adjusted for maternal weight, age, ethnicity, and gestational age.

Choice D is wrong because fetal demise (death) can also cause high levels of AFP in the maternal blood, as the AFP from the dead fetus can leak into the amniotic fluid and then into the maternal blood.

Normal ranges of AFP in pregnant women vary depending on the gestational age and the method of measurement.

Generally, normal levels of AFP are below 10 ng/ml in nonpregnant adults and below 2.5 MoM in pregnant women.

A maternal serum alpha-fetoprotein test is a type of prenatal blood test that measures the levels of MSAFP in the blood of a pregnant person.The test helps the healthcare provider assess the baby’s risk of certain medical conditions, such as neural tube defects and chromosomal abnormalities.The test is usually done between 15 and 20 weeks of pregnancy.

A screening test means that it does not diagnose any health conditions, but only indicates the probability of having them.

A positive test means that the baby has a higher risk of having a birth defect, but it does not confirm it.

A negative test means that the baby has a lower risk of having a birth defect, but it does not rule it out.Further tests are needed to confirm or exclude the diagnosis.

A diagnostic test means that it can provide a definite diagnosis of a health condition.A maternal serum alpha-fetoprotein test is not a diagnostic test for spinal defects or chromosomal abnormalities in the fetus.

Statement A is wrong because it says that the test is a diagnostic test for spinal defects in the fetus, which is not true.

Statement C is wrong because it says that the test is a diagnostic test for chromosomal abnormalities in the fetus, which is not true.

Statement D is wrong because it says that the test is a screening test for chromosomal abnormalities in the fetus, which is only partially true.The test can screen for some chromosomal abnormalities, such as Down syndrome, but not all of them.

The test also screens for neural tube defects, which are not chromosomal abnormalities.

Normal ranges for MSAFP vary depending on the gestational age and the laboratory methods used.Generally, MSAFP levels increase until about 32 weeks of pregnancy and then decrease until delivery.

High levels of MSAFP may indicate neural tube defects, multiple pregnancies, incorrect dating of pregnancy, or other conditions.Low levels of MSAFP may indicate Down syndrome, other chromosomal abnormalities, or other conditions.