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Use of Maternal Serum Alpha-Fetoprotein in Predicting Pregnancy Complications and Adverse Outcomes: Contribution of Supplemental Biomarkers (pp.97-124) $100.00
Authors:  (G.J. Mizejewski, Wadsworth Center, Division of Translational Medicine, New York State Department of Health, Empire State Plaza, Albany, New York, USA)
Abstract:
Human Alpha-fetoprotein (AFP) is a 70 kD tumor-associated fetal protein (Oncofetal Protein) which has been clinically utilized as a biomarker for both multiple cancer types and for fetal defects and malformations. The various functions attributed to AFP have included immunomodulation, growth, angiogenesis regulation, blood carrier transport, and cytoplasmic signal transduction. Fetal AFP traverses the placenta by a receptor/active transport mechanism, and enters the maternal blood circulation via the uterine blood vasculature. Aside from the detection of neural tube defects and chromosomal abnormalities in prenatal screening programs, maternal serum (MS) AFP in combination with supplemental pregnancy biomarkers are now being considered as predictors of pregnancy complications and adverse outcomes. The objective of the present chapter is to survey the use of MSAFP to detect and identify a variety of gestational conditions that could compromise the fetus, the placental unit, or the maternal uterine interface. Using MSAFP alone or in combination with supplemental biomarkers, multiple MS profiles and patterns have been found that foreshadowed various abnormal states and situations that could endanger the pregnancy. Such conditions included preterm birth, threatened abortion, placental previa/accreta, molar placenta, blighted ova, fetal growth restriction, intrauterine growth retardation, oligohydraminos, pre-eclampsia, and others. Thus, the
use of MSAFP together with other gestational-age-dependent biomarkers may someday serve as risk indicators for the prediction of endangered pregnancy states. Such MS profiles and/or patterns could provide tools for the perinatologist to more closely scrutinize and monitor pregnancy progression, and if needed, to anticipate and prepare for a difficult delivery and/or an unexpected complication at term. Present results might aid in providing new insights into research concerning pregnancy outcome predictions based on various combinations of biomarker profiles and patterns. 


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Use of Maternal Serum Alpha-Fetoprotein in Predicting Pregnancy Complications and Adverse Outcomes: Contribution of Supplemental Biomarkers (pp.97-124)