Wilkins-Haug L
Antenatal Diagnostic Center, Brigham and Women's Hospital, Boston, MA 02115, USA.
Curr Opin Obstet Gynecol. 1998 Dec;10(6):469-74. doi: 10.1097/00001703-199812000-00007.
Unexplained elevations of maternal serum alpha-fetoprotein exist in approximately 1% of the obstetric population. A consensus has been reached that these women face an increased risk of adverse pregnancy outcome. Whether their overall risk can be altered by the currently available surveillance modalities, however, remains controversial. Current research has focused on identifying those pregnancies with the highest risks of either fetal growth restriction, pre-eclampsia, preterm delivery or intrauterine fetal demise. Markedly increased maternal serum alpha-fetoprotein (over 4.0 multiples of the median), elevations of other serum markers such as human chorionic gonadotropin and abnormal umbilical Doppler flow are associated with the greatest risk of poor pregnancy outcome. When initiating surveillance of the pregnancy with unexplained elevated maternal serum alpha-fetoprotein consideration of these factors is receiving increased attention.
在大约1%的产科人群中存在不明原因的母体血清甲胎蛋白升高情况。人们已达成共识，即这些女性面临不良妊娠结局风险增加的情况。然而，目前可用的监测方式能否改变她们的总体风险仍存在争议。当前的研究集中在识别那些胎儿生长受限、先兆子痫、早产或宫内胎儿死亡风险最高的妊娠。母体血清甲胎蛋白显著升高（超过中位数的4.0倍）、人绒毛膜促性腺激素等其他血清标志物升高以及脐动脉多普勒血流异常与不良妊娠结局的最大风险相关。在对不明原因母体血清甲胎蛋白升高的妊娠开始进行监测时，对这些因素的考虑正受到越来越多的关注。
