[Clinical studies on maternal serum alpha-fetoprotein (MSAFP) of 532 cases--the median value, pregnancy outcomes and clinical evaluation].

MSAFP screening program has gradually become widespread. Prenatal diagnosis of fetal anomalies by means of the MSAFP level has become increasingly integrated into the routine components of obstetric management. During the period from June, 1990 through January, 1991, 516 pregnant women between 12 and 19 weeks' gestation participated in MSAFP screening and there were 532 MSAFP cases including repeat 16 cases for which follow-up data have been completed. 1. Of this population, 5 cases (0.9%) had increased MSAFP (> or = 2.5MOM). One case was IUFD, one case was twin, one case was Breus' mole, two cases had normal repeat MSAFP levels. Thirty-three cases (6.2%) had low MSAFP (0.5 < or = MOM). One abnormal karyotype (46,XY,16p+) was discovered among twenty-six cases by undergoing amniocentesis (3.8%). 2. Of the four hundred ninety-four cases (92.8%) with a normal MSAFP level, thirty-three (6.9%) had an adverse pregnant outcome. Eight cases were prematurity, eight cases were low birth weight infants, six cases were large-for-date infants, two cases were IUFD, one case was Klinefelter's syndrome, one case had cystic hygroma and one case was had a tracheo-esophageal fistula. 3. A woman with an extremely high MSAFP level, with normal ultrasonography and with normal amniocentesis results should be regarded as a high-risk pregnancy and need further close follow-up to detect placental abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)