This article is from the Pregnancy Screening FAQ, by Lynn Gazis-Sax (gazissax@netcom.com) with numerous contributions by others.
Your caregiver should recommend an ultrasound to get a more accurate dating
and to rule out multiple fetuses. Over 90% of the time, abnormal AFP values
are due to these or other benign factors. Then a second AFP test might be
run. If that is also abnormal, a more sophisticated ultrasound and
amniocentesis would be suggested. The diagnosis of neural tube defects
usually requires a combination of AFP testing, ultrasound and
amniocentesis. Diagnosing Down's requires amniocentesis, but an ultrasound
can be suggestive (see next question).
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Addition by Dr. Tim Reynolds:
It is best to get amnio first as this prevents the anxiety!
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Since time and worry can be an issue, perhaps you and your caregiver will
decide to get the more sophisticated level 2 ultrasound on the basis of one
abnormal test. This is something that you should discuss with your
caregiver.
 
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