Family Nurse Practitioner Exam

What would you expect the alpha fetoprotein (AFP) values to be in a 35-year-old primigravida expecting twins?

1. Normal

2. Higher than normal

3. Lower than normal

4. None of the above

The correct answer is: Higher than normal

In the case of a 35-year-old primigravida who is expecting twins, it is expected that the alpha fetoprotein (AFP) levels would be higher than normal. This is primarily because AFP is a protein produced by the fetal liver, and its production increases with the number of fetuses. In singleton pregnancies, AFP levels have a specific reference range, but during multiple gestations, elevated levels of AFP are commonly observed due to the greater amount of fetal tissue producing the protein. The increase in AFP can help in the assessment of potential fetal conditions, and in the context of multiple gestations, higher AFP levels are generally not indicative of pathology. They are simply a reflection of the increased fetal mass and metabolic activity. Thus, in a twin pregnancy, a significant elevation in AFP is typical and expected.