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Alpha fetoprotein

Alternative names: fetal alpha globulin; AFP

Definition:

A test that measures the amount of alpha fetoprotein (AFP) in serum (blood).

How the test is performed:

Adult or child:

Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

Infant or young child:

The area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a pipette (small glass tube), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

How to prepare for the test:

Adult:

There is no special preparation.

Infants and children:

The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

infant test or procedure preparation (birth to 1 year)

toddler test or procedure preparation (1 to 3 years)

preschooler test or procedure preparation (3 to 6 years)

schoolage test or procedure preparation (6 to 12 years)

adolescent test or procedure preparation (12 to 18 years)

How the test will feel:

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

What the risks are:

excessive bleeding

fainting or feeling lightheaded

hematoma (blood accumulating under the skin)

infection (a slight risk any time the skin is broken)

multiple punctures to locate veins

Why the test is performed:

AFP is measured to diagnose or monitor fetal distress or fetal abnormalities, some liver disorders, and some cancers. This test has been used to determine the progress of therapy for hepatitis or liver disease. During pregnancy, this test, along with the examination of amniotic fluid (amniocentesis), can help detect fetal spinal bifida or other defects of the fetus’ neural tube.

AFP is a protein normally produced by the liver and yolk sac of a fetus, where it has an analogous function to albumin levels increase soon after birth; AFP probably has no normal function in adults.

Normal values:

Males or nonpregnant females: less than 300 ng/ml

Note: ng/ml = nanograms per milliliter

What abnormal results mean:

Greater-than-normal levels of AFP may indicate:

cancer in testes, ovaries, biliary (liver secretion) tract, stomach, or pancreas

cirrhosis of the liver

liver cancer

malignant teratoma

recovery from hepatitis

During pregnancy, increased levels of AFP may indicate:

fetal defects

spina bifida

anencephaly

omphalocele

tetralogy of Fallot

duodenal atresia

Turner’s syndrome

intrauterine death (usually results in a miscarriage)

Additional conditions under which the test may be performed:

testicular cancer