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Maternal Serum Alpha-Fetoprotein (MSAFP) Screening

All You Need to Know About Maternal Serum Alpha-Fetoprotein (MSAFP) Test

3 min readUpdated August 12, 2021

Around the second trimester, you are likely to get some screening tests done. One of these tests will check the alpha-fetoprotein levels produced by your baby. This test helps in assessing your baby's risk of a chromosomal abnormality or a neural tube defect. The name of this screening test is the maternal serum alpha-fetoprotein test (MSAFP).

We’ve curated some common questions about the maternal serum alpha-fetoprotein test to help you understand everything about it. So, keep reading!

What Is Maternal Serum Alpha-Fetoprotein?

Alpha-fetoprotein (AFP) is produced by your little one as she grows and develops inside your womb. Although AFP is produced by the baby, it enters the mother's blood through the placenta. Hence, it is called a maternal serum alpha-fetoprotein (MSAFP) test.

A very high level of AFP in your body may signify a risk of neural tube defect, like spina bifida, to your baby. Spina bifida occurs when there's an incomplete development of the brain and spinal cord. A very low level of AFP may denote a chromosomal abnormality, like down syndrome, in your baby.

What Is a Maternal Serum Alpha-Fetoprotein Screening Test?

A maternal serum alpha-fetoprotein screening is a prenatal blood test to check the levels of MSAFP in your body. MSAFP is commonly recommended to all expecting moms as a part of prenatal care during the second trimester of pregnancy. This test helps your doctor to check whether your baby is at risk of certain medical conditions.

If you're in doubt about whether to take this screening test, ask your doctor about what is recommended for your situation. You can then make an informed choice accordingly.

When Is an MSAFP Test Done?

An MSAFP test is usually recommended in the second trimester between 16 weeks and 18 weeks of pregnancy. It's typically done as part of a quadruple screening test or quad screen. Apart from testing for MSAFP, this test also checks for the pregnancy hormones inhibin-A, hCG, and estriol.

What Is an Integrated Screening?

The first-trimester screen results, including a nuchal translucency screening along with the quadruple screen tests, including the MSAFP test, are checked by your doctor to understand your baby’s health. These tests together are sometimes referred to as integrated screening.

By looking at all these prenatal scans and test results together, your doctor may be able to determine whether your little one is at risk of certain birth defects or medical conditions. These include chromosomal abnormalities such as trisomy 18 and down syndrome (trisomy 21) or a neural tube defect such as spina bifida.

What Do the Maternal Serum Alpha-Fetoprotein Levels Mean?

Too much MSAFP could denote a neural tube defect like spina bifida, whereas too few levels could signify a chromosomal abnormality like Down syndrome. Your doctor is the best expert to assess the risk levels after taking a look at the test results.

What If Your MSAFP Test Result Is Not in the Normal Range?

After considering other factors like your age, your doctor can determine your baby's risk level of having a certain medical condition using the MSAFP test results. Remember, each testing laboratory can have a different range to determine the risk. Hence, it is better to ask your doctor to confirm the results for you.

Keep in mind that the MSAFP test only helps your doctor evaluate your baby's risk of having certain medical conditions after birth. Remember, you have a minimal chance of getting a positive result. However, if your doctor confirms that your baby is at risk, you may be recommended to undergo further diagnostic tests. Your doctor might recommend amniocentesis during the second trimester to make a diagnosis.

For the amniocentesis test, your amniotic fluid sample is collected. Your doctor can explain to you the risks and benefits of these diagnostic tests so that you can choose how you want to proceed. It's normal to look for reassurance that everything is alright with your baby. Tests like MSAFP can provide vital information about your baby, contributing to an overall evaluation of your baby's health.

Although a rare chance, if your screening test result is positive, your doctor will explain the results to you. He might recommend some extra diagnostic tests. Your doctor will provide you with personalised guidance and be there with you at every step of the journey, helping you make informed decisions that you are comfortable with.

What Are the Risks Of MSAFP?

Other than the normal risks of a blood test, there are no major risks of MSAFP. Also, note that a multiple marker screening test is not diagnostic, which means it isn't 100% accurate. It is just a screening test to determine if you need more tests for your pregnancy. There can also be false-positive results, indicating a problem when the baby is actually healthy. Plus, there can also be false-negative results, showing everything to be alright when the baby actually has a health problem.

What Are the Benefits Of MSAFP?

This screening test helps to find out whether your baby has a higher risk of a birth defect. Plus, it helps determine if you need any additional tests during pregnancy. It would be difficult to recommend extra tests without the AFP test.

As you move ahead in your journey, know what is in store for you each week, month, and trimester with our useful and informative pregnancy calendar.

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