High maternal serum alpha-fetoprotein levels during the 2nd trimester of pregnancy: diagnostic approach.

The limit of the classic diagnostic protocols following the evidence of high maternal serum alpha-fetoprotein levels is represented by the high number of amniocenteses performed and that, in the most part of cases, give false negative results. Now days the introduction of high resolution ecographic equipments allows to us, in many cases, to clarify the diagnostic without further examinations. The Authors propose a diagnostic protocol that include the execution of high resolution ultrasound at the second withdrawal of serum alpha-fetoprotein, limiting the use of amniocentesis only when is necessary to determine the fetal karyotype. An high sensibility diagnostic system with a favourable cost/benefit ratio results from this approach.