Alpha-fetoprotein (AFP) Lab Values

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Abby Rose
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Outline

Objective:

Determine the significance and clinical use of AFP – Alpha-fetoprotein Lab Value in clinical practice

 

Lab Test Name:

AFP – Alpha-Fetoprotein Test

 

Description:

AFP: Alpha-fetoprotein- 

  • Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus. 
  • AFP crosses the placenta and into the pregnant woman’s blood. 
  • Level of AFP in pregnant women during the second trimester of pregnancy. 
  • Values outside normal limits may be sign of a birth defect or other condition

 

Indications:

The American Pregnancy Association recommends that all pregnant women should be evaluated with an AFP test during their second trimester of pregnancy. Sometime between the 15th and 20th week of pregnancy. 

The test may be especially recommended to those who:

  • Have a family history of birth defects
  • Are 35 years or older
  • Have diabetes

 

Normal Therapeutic Values:

AFP – 

During pregnancy

  • Levels rise from week 14 to 32 weeks during gestation
  • Between 15 and 20 weeks gestation
  • 10-150 ng/ml

Men and non-pregnant women

  • 0-40 ng/ml

Collection:

  • Plain red tube
  • Serum separator

 

What would cause increased levels?

Increased: 

  • Neural tube defect
    • Spina bifida- a defect in bone development of the spinal column, where the bones don’t form around the spinal cord
    • Anencephaly- improper brain development

 

What would cause decreased levels?

DECREASED:

  • Potential genetic disorder
    • Down syndrome
      • Condition that causes intellectual and developmental issues

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Transcript

Hey there, Abby from nursing.com here. In this lesson, we’re going to discuss a lab value called Alpha-fetoprotein. It’s abbreviated as AFP. We’ll talk about the normal value and also some clinical presentations or indications for why it might be increased or decreased. Let’s get started.

 

Alpha-fetoprotein is a lab that measures the level of AFP in the blood. AFP is produced in the yolk SAC and the fetal liver. So, during gestation, this lab is used to monitor fetal development and typically drawn during the second trimester of pregnancy. Some clinical indications or some presentations of what we might see for this lab value to be drawn, is it has to be or recommended to be in the second trimester pregnancy. Uh, it’s recommended if someone that is pregnant has a family history of birth effects. If they’re 35 years or older, which is considered a high risk pregnancy, or someone that has diabetes. Normal therapeutic values, particularly during pregnancy, the levels rise between week 14 and 32, and then it’s tested between 15 and 20 weeks gestation. That’s the recommendation. So, between 10 and 150 nanograms per milliliter is the normal value for men and non-pregnant women.

 

The normal value is zero to 40 nanograms per milliliter. This lab is collected in a plain red tube, or it can also be in a serum separator. An increased lab value indicates a neural tube defect. Now, remember this lab is being drawn in the second trimester of pregnancy. So, this could be a very sensitive topic, right? So, if it indicates a neural tube defect, that could mean spina bifida or anencephaly.. This is a picture of what spina bifida looks like. What happens is, the bones don’t actually form around the spinal cord and contain it. Therefore it’s a defect in development. And then, anencephaly is a condition that leads to improper brain development,  so pretty serious side effects. A decreased lab value can lead to potential genetic disorders like down syndrome or trisomy 21 like this little cutie right here. 

 

Our linchpins for this lesson are that alpha-fetoprotein monitors fetal development. It’s drawn during the second trimester between 15 and 20 weeks. A normal value for a pregnant woman is between 10 and 150 nanograms per milliliter in reference to this lab. That’s most often when you’ll see it is in reference to pregnancy. An increase in the lab value detects neural tube defects, and a decreased lab value detects genetic disorders or the possibility therein. 

 

Now, you’ve all done great in this lesson and this wraps it up. Remember, we love you guys. We know you can do this, so go out and be your best self today and as always, happy nursing!

References:

National Library of Medicine (n.d.). Alpha fetoprotein test.

Stoppler, M.C., & Davis, P. (n.d.). Alpha-fetoprotein blood test.

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Concepts Covered:

  • Labor Complications
  • Fetal Development
  • Terminology
  • Pregnancy Risks
  • Newborn Complications
  • Postpartum Care
  • Prenatal Concepts
  • Newborn Care
  • Postpartum Complications
  • Labor and Delivery
  • Studying
  • Communication
  • Medication Administration

Study Plan Lessons

Abruptio Placenta for Certified Emergency Nursing (CEN)
Adult Vital Signs (VS)
Alpha-fetoprotein (AFP) Lab Values
Antepartum Testing
Anti-Infective – Aminoglycosides
Anti-Infective – Lincosamide
Bicarbonate (HCO3) Lab Values
Blood Cultures
Blood Transfusions (Administration)
Body System Assessments
Breastfeeding
Cardiac (Heart) Disease in Pregnancy
Certified Nurse Midwife
Chorioamnionitis
Clindamycin (Cleocin) Nursing Considerations
Direct Bilirubin (Conjugated) Lab Values
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Emergent Delivery (OB) (30 min)
Emergent Delivery for Certified Emergency Nursing (CEN)
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Family Planning & Signs of Pregnancy – Live Tutoring Archive
Fetal Alcohol Syndrome (FAS)
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemoglobin A1c (HbA1C)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hyperbilirubinemia (Jaundice)
Hypovolemic Shock Case Study (OB sim) (60 min)
Initial Care of the Newborn (APGAR)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Maternal Risk Factors
Newborn Physical Exam
Newborn Reflexes
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Hypertension (HTN)
Nursing Care Plan (NCP) for Incompetent Cervix
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Maternal Newborn
Nutrition Assessments
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Course Introduction
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Obstetric Trauma for Certified Emergency Nursing (CEN)
Obstetrical Procedures
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Placenta Previa for Certified Emergency Nursing (CEN)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Interventions
Precipitous Labor
Pregnancy Labs
Preterm Labor for Certified Emergency Nursing (CEN)
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor – Live Tutoring Archive
Process of Labor 2 – Live Tutoring Archive
Protein (PROT) Lab Values
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Signs of Pregnancy – Live Tutoring Archive
Signs of Pregnancy (Presumptive, Probable, Positive)
Top 5 Misunderstood OB Concepts – Live Tutoring Archive