Review Maternal Serum Alpha-Fetoprotein (MSAFP) Test

Prenatal Diagnostic Tests And Procedures > Maternal & Newborn

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Maternal Serum Alpha-Fetoprotein (MSAFP) Test

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Total Questions : 5

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Question 1:

A nurse is explaining the purpose of the Maternal Serum Alpha-Fetoprotein (MSAFP) test to a pregnant client.

What does this test primarily detect?

A. Renal anomalies. B. Fetal growth and development. C. Chromosomal abnormalities. D. Abdominal wall defects.

Answer and Explanation

Choice A:

Renal anomalies are not detected by the MSAFP test. Renal anomalies are problems with the kidneys or urinary tract of the baby.

Choice B:

Fetal growth and development are not detected by the MSAFP test. Fetal growth and development are assessed by other prenatal tests, such as ultrasound scans.

Choice C:

Chromosomal abnormalities are not detected by the MSAFP test alone. Chromosomal abnormalities are genetic disorders that affect the number or structure of the chromosomes in the baby’s cells. The MSAFP test may be combined with other tests, such as hCG, estriol, and inhibin-A, to form a quadruple screening test (or quad screen) that can check the baby’s risk of chromosomal abnormalities, such as Down syndrome.

Choice D:

This is because the Maternal Serum Alpha-Fetoprotein (MSAFP) test primarily detects the level of alpha-fetoprotein (AFP) in the blood of a pregnant person. AFP is a protein that a developing baby makes and normally passes into the mother’s bloodstream. Too much AFP may indicate that the baby has a neural tube defect or an abdominal wall defect, which are conditions that cause abnormal development of the baby’s body. An abdominal wall defect is a hole in the muscles and skin that cover the abdomen, which allows some of the baby’s organs to protrude outside the body.

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Question 2:

A client is scheduled to undergo the MSAFP test.

When is this test typically performed?

A. During the first trimester of pregnancy. B. Between 11 and 14 weeks of gestation. C. Between 15 and 20 weeks of gestation. D. During the third trimester of pregnancy.

Answer and Explanation

Choice A:

The MSAFP test is not done during the first trimester of pregnancy. The first trimester screening usually includes a nuchal translucency screening, which measures the fluid at the back of the fetus’s neck to assess the risk of Down syndrome.

Choice B:

The MSAFP test is not done between 11 and 14 weeks of gestation. This is too early to detect the level of AFP in the mother’s blood. The MSAFP test is most accurate between 16 and 18 weeks of pregnancy.

Choice C:

This is because the maternal serum alpha-fetoprotein (MSAFP) test is a screening tool indicated for all high-risk pregnant clients between 15 and 20 weeks gestation. The test measures the level of alpha-fetoprotein (AFP) in the mother’s blood, which is produced by the fetus and can indicate certain birth defects or chromosomal abnormalities.

Choice D:

wrong

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Question 3:

A nurse is reviewing the MSAFP test results with a client.

A high level of MSAFP (>2.5 MoM) may indicate which of the following conditions?

A. Chromosomal abnormalities. B. Fetal demise. C. Neural tube defect. D. Multiple gestation.

Answer and Explanation

Choice A:

Chromosomal abnormalities such as Down syndrome are associated with low levels of MSAFP, not high levels. Chromosomal abnormalities involve an extra or missing chromosome that affects the fetus’s development.

Choice B:

Fetal demise or death is not related to MSAFP levels. Fetal demise can be caused by various factors such as infections, placental problems, or umbilical cord accidents.

Choice C:

A high level of MSAFP (>2.5 MoM) may indicate that the fetus has a neural tube defect such as spina bifida, which results from incomplete development of the brain and spinal cord. A neural tube defect causes an opening in the head, spine, or stomach wall that allows high levels of AFP to enter the mother’s blood.

Choice D:

Multiple gestation or having more than one fetus can also cause low levels of MSAFP, not high levels. Multiple gestation increases the risk of complications such as preterm labor, preeclampsia, and fetal growth restriction.

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Question 4:

A pregnant client asks the nurse about the risks associated with the MSAFP test.

What is the nurse's best response?

A. "The MSAFP test carries a risk of miscarriage.". B. "There are no risks or complications associated with the MSAFP test.". C. "The MSAFP test may cause harm to the fetus.". D. "Pregnant individuals should avoid the MSAFP test due to potential radiation exposure.".

Answer and Explanation

Choice A:

“The MSAFP test carries a risk of miscarriage.” This statement is wrong because the MSAFP test is a blood test that does not involve any invasive procedures or harm to the baby.

Choice B:

The MSAFP test is a screening test that measures the amount of alpha-fetoprotein (AFP) in the mother’s blood. AFP is a protein produced by the baby during pregnancy. The test helps to assess the baby’s risk of certain birth defects, such as neural tube defects or chromosomal abnormalities.

Choice C:

“The MSAFP test may cause harm to the fetus.” This statement is wrong because the MSAFP test does not affect the fetus in any way. It only measures the amount of AFP in the mother’s blood.

Choice D:

“Pregnant individuals should avoid the MSAFP test due to potential radiation exposure.” This statement is wrong because the MSAFP test does not involve any radiation exposure. It is a simple blood test that uses a needle to draw blood from a vein.

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Question 5:

A nurse is providing education to a client about the MSAFP test.

Which of the following statements accurately describes the MSAFP results?

A. MSAFP results are diagnostic and confirm the presence of fetal anomalies. B. MSAFP results require no further evaluation or testing. C. MSAFP results are reported as multiples of the median (MoM) and require further evaluation. D. MSAFP results indicate the gestational age of the fetu.

Answer and Explanation

Choice A:

MSAFP results are not diagnostic and do not confirm the presence of fetal anomalies. They only indicate the risk of certain conditions and the need for further evaluation.

Choice B:

MSAFP results require further evaluation or testing if they are abnormal. A normal MSAFP result does not rule out the possibility of fetal anomalies, nor does it guarantee a healthy outcome.

Choice C:

This is because MSAFP is a screening test that measures the level of alpha-fetoprotein (AFP) in the maternal blood, which is produced by the fetus. The MoM value compares the AFP level of the mother to the average level for women of the same gestational age. A MoM value that is too high or too low may indicate a risk of certain fetal anomalies, such as neural tube defects or chromosomal abnormalities. However, MSAFP results are not diagnostic and do not confirm the presence or absence of any condition. They only indicate the need for further testing, such as ultrasound, amniocentesis, or chorionic villus sampling.

Choice D:

MSAFP results do not indicate the gestational age of the fetus. They are compared to the average level for women of the same gestational age to calculate the MoM value. Gestational age can be estimated by other methods, such as ultrasound or last menstrual period.

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Maternal Serum Alpha-Fetoprotein (MSAFP) Test

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