Alpha Feto Protein (AFP) Test

What is AFP?

AFP stands for Alpha Feto Protein. It is a glycoprotein that is formed in the yolk sac of the mother. It is a fetus specific protein that is formed only in the GI(gastrointestinal) tract and the liver of a developing fetus. Then it gets gradually circulated in the fetal as well as the maternal blood.
 

What is the prevalence of live births with birth defects in India?

Nearly 6-7% of the newborns are affected by various birth defects. Annually, there are 1.7 million kids born with birth defects. 

What is AFP (Alpha FetoProtein) Test?

AFP (Alpha FetoProtein) Test is the blood test that is conducted for screening the amount of AFP(Alpha Feto Protein) in the blood. It forms a very integral part of pregnancy health care. This test is recommended usually between the 14th-22nd week of pregnancy. AFP(Alpha FetoProtein) Test is a part of triple or quad screening.

Why did my doctor recommend me an AFP(Alpha FetoProtein) Test?

During pregnancy, your doctor might suggest an AFP(Alpha FetoProtein) Test as a part of your regular pregnancy screening. It is recommended by your doctor in between the 14th to the 22nd week of pregnancy. It’s most accurate between the 16th to 18th week of pregnancy.

If you are not pregnant and yet have been recommended to undergo AFP(Alpha FetoProtein), it is used for the diagnosis of various adverse liver conditions. The most common liver conditions which are diagnosed are:
Liver cancer.
Liver cirrhosis.
Hepatitis. 

What are the other health conditions that AFP(Alpha FetoProtein) Test diagnose?

There are certain other health conditions that are diagnosed by AFP(Alpha FetoProtein):

– Testes Cancer.
– Ovaries Cancer.
– Biliary-tract Cancer.
– Stomach Cancer.
– Pancreas Cancer.

When do I need an AFP(Alpha FetoProtein) Test?

– AFP(Alpha FetoProtein) Test is highly required if you are in the second trimester of your pregnancy.

– This test is especially recommended to the women who have high risks of giving birth to children with various birth defects.

– Women who are 35 or above are recommended to undergo this test.

– Women with a family history of birth defects are highly recommended to go through the test. It saves the baby from any risk of open neural tube defects.

– Women having diabetes are also suggested undergoing the AFP(Alpha FetoProtein) Test.
 

Is AFP(Alpha FetoProtein) Test recommended for men?

In the case of men, this test recommended for diagnosing various liver defects like liver cancer, liver cirrhosis, etc. This test can be used in men for diagnosing other kinds of cancers as well as testes cancer, pancreas cancer, & stomach cancer.

What are the preparations needed for the test?

There are no special preparations needed for this test.

– Fasting is not required.
– No new medications have to be added.
– The ongoing medications do not need to be stopped.

You can consult your practitioner for further inquiries since he will guide you according to your medical conditions.

What is the procedure of the blood sample collection for the test?

For the test to be conducted a blood sample has to be collected. The blood sample is collected in between the 14th – 22nd week of pregnancy. For best results, it is collected during the 16th – 18th week of pregnancy. The blood sample is collected by venipuncture. The procedure is as follows:
 
– A tourniquet is wrapped around the upper arm to make the veins more prominent.

– A syringe or needle is used to draw blood by puncturing the vein.

– The blood is drawn into the tube of the syringe.

– The tourniquet is unwrapped.

– An antiseptic is applied to the spot of venipuncture to avoid any infection.

– The spot of injection of the syringe is dabbed by a cotton swab or a bandage is put to stop any further bleeding.

The blood sample is then sent to the laboratory for the AFP(Alpha FetoProtein) Test.
 

What is the procedure of the amniotic fluid sample collection for the test?

The procedure of collection of the amniotic fluid and testing it is called amniocentesis.

– Position the patient properly.

– Sterilize the exposed area of the abdomen.

– Use an anesthetic to avoid any kind of pain.

– Then inject the ultrasound-guided hollow needle through the anterior abdominal wall into the amniotic cavity.

– Draw a sample of 15 to 20ml of amniotic fluid.

Send the sample to the laboratory for the AFP(Alpha Feto Protein) test.
 

Is the procedure painful?

The procedure has no pain associated with it. There can be a little pin-pricking pain during injecting the needle. 

What are the risks associated with this test?

There are some minute risks associated with the procedure of venipuncture.

– Some people feel light-headed and dizzy after the blood is drawn.

– It might cause Hematoma (blood accumulating under the skin causing a lump or bruise).

– There might be pain associated with too many punctures for finding a vein.
 
There are some risks associated with the amniocentesis process:

– Miscarriage.
– Preterm delivery.

What is the price of the test in India?

The price of AFP(Alpha FetoProtein) Test in India ranges from Rs 800-2500. It varies according to the diagnostic centres and their locations i.e. the city or the state they are located in.

When will I get my results?

In the case of pregnancy, you will get your results within a week or two. In the case of non-pregnant women and men, you will get the results within 24 to 36 hours of the test.
 

How to interpret my results?

– The normal range of AFP(Alpha FetoProtein) varies with gender and race. Most adult males and females have AFP(Alpha FetoProtein) ranging from 0-40 ng/ml(nanogram/millilitre). 

– The level of AFP(Alpha FetoProtein) gradually increases in a pregnant woman by the 14th week up until 32nd week. Between 15th to 20th week, the AFP ranges from 10-150 ng/ml.
 
– If your AFP(Alpha FetoProtein) level is more than 200ng/ml, it indicates an abnormal increase in the AFP levels which has several adverse health effects like liver cirrhosis, hepatocellular carcinoma, etc.
 

What do abnormal levels of AFP(Alpha Feto Protein) indicate in pregnant women?

Higher levels of AFP(Alpha FetoProtein) in a pregnant woman indicates the following issues in the fetus:

– Neural tube defects (e.g., spina bifida, anencephaly).
– Omphalocele.
– Gastroschisis.

Whereas a lower level of AFP(Alpha FetoProtein) can lead to Down’s Syndrome in the fetus. 

What do higher levels of AFP(Alpha FetoProtein) indicate in non-pregnant women?

– Hepatocellular cancer.
– Metastatic liver cancer.
– Liver cirrhosis.
– Hepatitis.
– Germ cell tumors.
– Yolk sac tumor.
– Ataxia-telangiectasia.

What are the other tests associated with AFP(Alpha FetoProtein)?

During pregnancy, these are the following tests which are recommended along with AFP:
 
– Human chorionic gonadotropin (HCG).

– Estriol, which is a hormone produced by your placenta and your baby’s liver.

– Inhibin A, which is a hormone produced by your placenta.

– Lactate dehydrogenase, or LDH.
 
For non-pregnant women and men, the test associated with AFP(Alpha FetoProtein) test can include:
 
– Liver function tests, or LFTs.
-Blood clotting tests.
-Blood urea nitrogen, or BUN, and creatinine level tests.
–Complete blood count, or CBC.
-Electrolytes and blood chemistry tests.
-Viral hepatitis tests.
 

Is AFP (Alpha FetoProtein) Test recommended for kids?

Early detection of hepatoblastoma in the children suffering from Beckwith-Wiedemann syndrome or isolated hemihyperplasia can be done using AFP (Alpha FetoProtein) Test in combination with an abdominal ultrasound.

Is AFP (Alpha FetoProtein) Test safe for kids?

It is a completely safe process for kids since it involves the collection of the blood sample. It has no risks except for the risks associated with the venipuncture process.

What are the benefits and limitations of this test?