الفهرس 
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Abstract
The unexplained second trimester MSAFP elevation was significantly associated with poor maternal/fetal outcomes. In patients where the fetus is structurally normal, elevated MSAFP indicates a defect in the placentation.
Although unexplained high MSAFP values are associated with an increased risk of pregnancy complications, there is no consensus on the need for the observation of these pregnant women or on the methods to be implemented for monitoring these patients. Due to the low sensitivity of MSAFP and its PPV, its use alone as a screening test to predict pregnancy complications can be considered appropriate.
Therefore, these pregnant women should be under close clinical follow-up and auxiliary testing should be carried out to improve maternal/fetal outcome and, eventually, to reduce perinatal mortality and morbidity.
Furthermore, AFP with other serum markers, particularly hCG, in combination with uterine artery Doppler analysis can increase the recognition of pregnancy complications in women.
In addition, detailed pathological examination of the placenta following delivery can provide further information about the cause of MSAFP elevation.
Most previous studies did not show a significant relationship between more favorable outcomes and low MSAFP levels. On the contrary, several reports demonstrated an increased risk of poor pregnancy outcomes with low MSAFP levels.
Conclusion
As a result of our research, unexplained AFP rates have been found related to adverse perinatal outcomes. Pregnancies in which AFP rates increasing are being more complicated with adverse perinatal outcomes more and in a more serious manner than pregnancies in which rates increase one by one.
In the second trimester screening test, without the chromosomal or structural anomaly in a single pregnancy whose pregnancy week calculation is correct, increased AFP levels must be stimulant in terms of adverse perinatal outcomes, and by starting the follow-up in early period, effort should be made for increasing the fetal survival.
Prospective studies are needed for decreasing adverse perinatal outcomes.