Test Code AFPA Alpha-Fetoprotein, Amniotic Fluid
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
ACHE_ | Acetylcholinesterase, AF | Yes | No |
Testing Algorithm
If alpha-fetoprotein is positive, then acetylcholinesterase will be performed at an additional charge.
Performing Laboratory

Specimen Type
Amniotic FldNecessary Information
The following information is required:
1. Estimated due date by ultrasound
2. Collection date
3. Gestational age must be between 13 and 24 weeks; 16 to 18 weeks preferred.
If not ordering electronically, provide information on Second Trimester Maternal Screening Alpha-Fetoprotein / Quad Screen Patient Information (T595) and send with specimen.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Container/Tube: Plain, plastic, screw-top tube
Specimen Volume: 0.75 mL
Collection Instructions: Do not centrifuge.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Amniotic Fld | Refrigerated (preferred) | 7 days | |
Ambient | 7 days |
Reference Values
< 2.0 multiples of median (MoM)
Day(s) Performed
Monday through Friday
CPT Code Information
82106
82013 (if appropriate)
Clinical Information
Alpha-fetoprotein (AFP) is a single polypeptide chain glycoprotein with a molecular weight of approximately 70,000 Da. Synthesis of AFP occurs primarily in the liver and yolk sac of the fetus. It is secreted in fetal serum, reaching a peak at approximately 13 weeks gestation, after which it rapidly declines until about 22 weeks gestation and then gradually declines until term. Transfer of AFP into maternal circulation is accomplished primarily through diffusion across the placenta. Maternal serum AFP levels rise from the normal non-pregnancy level of 0.20 ng/mL to about 250 ng/mL at 32 weeks gestation.
If the fetus has an open neural tube defect, AFP is thought to leak directly into the amniotic fluid, causing unexpectedly high concentrations of AFP. Other fetal abnormalities such as omphalocele, gastroschisis, congenital kidney disease, and esophageal atresia; and other fetal distress situations such as threatened abortion, prematurity, and fetal demise, may also show AFP elevations. Decreased amniotic fluid AFP values may be seen when gestational age has been overestimated.
Report Available
2 to 19 daysReject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Method Name
AFPA: Immunoenzymatic Assay
ACHE_: Polyacrylamide Electrophoresis
Forms
Second Trimester Maternal Screening Alpha-Fetoprotein / Quad Screen Patient Information (T595) is required.