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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OB

Concepts Covered:

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

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Alpha-fetoprotein (AFP) Lab Values
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Babies by Term
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Chorioamnionitis
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Emergent Delivery (OB) (30 min)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Heart Monitoring (FHM)
Fetal Environment
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational HTN (Hypertension)
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hyperemesis Gravidarum
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant for Newborns
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Menstrual Cycle
Newborn of HIV+ Mother
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 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 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 for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Case Study for Maternal Newborn
Nutrition in Pregnancy
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Non-Stress Test Results Nursing Mnemonic (NNN)
Obstetric Trauma for Certified Emergency Nursing (CEN)
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Phytonadione (Vitamin K) for Newborn
Placenta Previa for Certified Emergency Nursing (CEN)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Interventions
Postpartum Physiological Maternal Changes
Preeclampsia (45 min)
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preterm Labor for Certified Emergency Nursing (CEN)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Prolapsed Umbilical Cord
Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Signs of Pregnancy (Presumptive, Probable, Positive)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Tips & Advice for Newborns (Neonatal IV Insertion)
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Tocolytics
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)