{"id":219,"date":"2025-06-11T12:38:48","date_gmt":"2025-06-11T12:38:48","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=219"},"modified":"2025-08-08T13:57:34","modified_gmt":"2025-08-08T13:57:34","slug":"afp-alfa-feto-proteina-marker-sarcina-triplu-test","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/afp-alfa-feto-proteina-marker-sarcina-triplu-test\/","title":{"rendered":"AFP ( Alfa-feto proteina ) \u2013 Marker sarcina\/Triplu test"},"content":{"rendered":"<div class=\"info-content content-informatii-generale\">\n<h2><strong>Informa\u021bii generale AFP ( Alfa-feto proteina ) \u2013 Marker sarcina\/Triplu test<\/strong><\/h2>\n<p>Determinarea <strong>AFP<\/strong> serice este recomandat\u0103 \u00een screening prenatal pentru eviden\u021bierea defectelor de \u00eenchidere a tubului neural (exclusiv alfa-fetoproteina), trisomia 21 (alfa-fetoprotein\u0103 impreuna cu gonadotropin\u0103 corionic\u0103 umana- hGH, estriol liber ) \u0219i trisomia 18 (alfa-fetoprotein\u0103, gonadotropin\u0103 corionic\u0103 uman\u0103-hGH \u0219i <a href=\"https:\/\/www.synevo.ro\/shop\/estriol-neconjugat\/\" target=\"_blank\" rel=\"noopener\" data-wpel-link=\"internal\">estriol liber<\/a>).<\/p>\n<p>Alfa-fetoproteina (AFP) este o protein\u0103 fetal\u0103 sintetizat\u0103 \u00een ficat si intestin. Concentra\u021bia AFP cre\u0219te \u00een serul fetal, \u00eentre saptamanile 10 \u0219i 13<sup>1,2<\/sup>. AFP fetal difuzeaz\u0103 \u00een circula\u021bia matern\u0103 de-a lungul barierei vasculo-placentare. O cantitate mic\u0103 este transportat\u0103 din cavitatea amniotic\u0103. Concentra\u021bia de AFP \u00een serul matern cre\u0219te pe tot parcursul sarcinii, de la nivelul ini\u021bial (non-sarcin\u0103) de 0,2 ng\/mL, la aproximativ 250 ng\/mL la 32 s\u0103pt\u0103m\u00e2ni de gesta\u021bie<sup>3<\/sup>.<\/p>\n<p>Dac\u0103 f\u0103tul are un defect de tub neural (deschis), aceast\u0103 protein\u0103 se va scurge direct \u00een lichidul amniotic, determin\u00e2nd concentra\u021bii mari de AFP. Ulterior, AFP ajunge la circula\u021bia matern\u0103, gener\u00e2nd astfel niveluri serice crescute. Defectul de tub neural const\u0103 \u00een ne\u00eenchiderea sau \u00eenchiderea incomplet\u0103 a formatiunii embrionare din care se va forma sistemul nervos (cranian \u2013 encefalul, caudal \u2013 maduva spinarii).<\/p>\n<p>Acestea se mai numesc si <strong>disrafii <\/strong><sup>11.<\/sup> Alte anomalii fetale, cum ar fi bolile renale congenitale, atrezia esofagian\u0103 \u0219i altele (de exemplu, avort spontan) pot duce, de asemenea, la cre\u0219teri ale AFP serice ale mamei<sup>4<\/sup>. Cre\u0219terea concentra\u021biilor serice de AFP matern poate fi observat\u0103, de asemenea, \u00een sarcinile multiple \u0219i \u00een sarcinile cu f\u00e2t unic, neafectate, \u00een care v\u00e2rsta gesta\u021bional\u0103 a fost subestimat\u0103<sup>5<\/sup>.<\/p>\n<p>Concentra\u021biile sc\u0103zute ale AFP serice materne au fost asociate cu un risc crescut de afec\u021biuni genetice, cum ar fi trisomia 21 (<a href=\"https:\/\/www.synevo.ro\/sindromul-down-si-analizele-indicate-unei-gravide\/\" data-wpel-link=\"internal\">sindromul Down<\/a>) \u0219i trisomia 18 (sindromul Edwards). Acesta\u00a0 nu poate fi utilizat ca bimarker de diagnostic pentru acestea<sup>6<\/sup>.<\/p>\n<p>Determinarea valorilor serice ale AFP materne este un instrument standard utilizat \u00een evaluarea obstetrical\u0103, pentru a identifica sarcinile care pot avea un risc crescut de tub neural deschis. Evaluarea rezultatelor este realizat\u0103 prin determinarea AFP \u00een serul matern \u0219i compararea acestei valori cu valoarea AFP median\u0103 dintr-o popula\u021bie de gravide neafectate, pentru a ob\u021bine un multiplu al medianei (MoM)<sup>7<\/sup>.<\/p>\n<p>S-a stabilit o limit\u0103 a MoM de 2,5, care tran\u0219eaz\u0103 rezultatele \u00een pozitive sau negative. Un rezultat pozitiv indic\u0103 faptul c\u0103 valoarea ob\u021binut\u0103 dep\u0103\u0219e\u0219te limita de referin\u021b\u0103. Un rezultat pozitiv nu ofer\u0103 un diagnostic, dar indic\u0103 faptul c\u0103 ar trebui luat\u0103 \u00een considerare o evaluare suplimentar\u0103<sup>8,9<\/sup>.<\/p>\n<h2><strong>Recomand\u0103ri pentru determinarea alfa-fetoproteina<sup>6-10<\/sup><\/strong><\/h2>\n<ul>\n<li>Screening prenatal pentru defect de tub neural (deschis)<\/li>\n<\/ul>\n<p><strong>Specimen recoltat <\/strong>\u2013 s\u00e2nge venos<sup>10<\/sup><\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare <\/strong>\u2013 se centrifugheaz\u0103 imediat dup\u0103 recolt\u0103<sup>10<\/sup><\/p>\n<p><strong>Volum prob\u0103 <\/strong>\u2013 1 mL<sup>10<\/sup><\/p>\n<p><strong>Cauze de respingere a probei<\/strong><sup>10<\/sup><\/p>\n<ul>\n<li>Specimen hemolizat<\/li>\n<li>Specimen recoltat imediat dup\u0103 amniocentez\u0103<\/li>\n<\/ul>\n<p><strong>Stabilitate prob\u0103 <\/strong>\u2013 timp de 7 zile refrigerat<sup>10<\/sup><\/p>\n<p><strong>Metod\u0103 \u2013 <\/strong>imunoenzimatic\u0103 de tip sandwich<sup>10<\/sup><\/p>\n<h2><strong>Valori de referin\u021b\u0103 AFP ( Alfa-feto proteina ) \u2013 Marker sarcina\/Triplu test<\/strong><\/h2>\n<p>Un multiplu AFP al medianei (MoM) la valoarea de 2.5, este raportat ca fiind un rezultat negativ.<\/p>\n<p>Un rezultat negativ indic\u0103 faptul c\u0103 multiplul de median\u0103 calculat al alfa-fetoproteinei (AFP) (MoM) scade sub limita stabilit\u0103 de 2.50 MoM. Un rezultat negativ nu garanteaz\u0103 absen\u021ba defectelor de tub neural.<\/p>\n<p>Un rezultat pozitiv indic\u0103 faptul c\u0103 MoM calculat al AFP este de 2.50 sau mai mare \u0219i poate indica un risc crescut pentru tub neural deschis. Riscul actual depinde de nivelul de AFP \u0219i de istoricul familial, loca\u021bia geografic\u0103, afec\u021biunile materne, cum ar fi diabetul \u0219i epilepsia, \u0219i utilizarea medica\u021biei pe baz\u0103 de fola\u021bi, \u00eenainte de concep\u021bie.<\/p>\n<p>Un rezultat pozitiv nu certific\u0103 un diagnostic definitiv al unui defect de tub neural, dar semnaleaz\u0103 faptul c\u0103 ar trebui luat\u0103 \u00een considerare evalu\u0103ri suplimentare. Aproximativ 80% din sarcinile afectate cu defecte de tub neural au valori crescute ale AFP MoM, mai mari de 2.50.<\/p>\n<p><strong>Limite \u0219i interferen\u021be<\/strong><sup>10<\/sup><\/p>\n<p>Rasa, greutatea, fumatul, sarcina multipl\u0103 \u0219i diabetul insulino-dependent, pot afecta concentra\u021biile biomarkerului. Fumatul poate determina o valoare a AFP seric matern mai mare \u00een al doilea trimestru. Valorile MoM sunt ajustate \u00een mod corespunz\u0103tor, pentru a \u021bine cont de diferen\u021bele serice de AFP la fum\u0103tori, ras\u0103, greutate, tipul sarcinii \u0219i afec\u021biunile diagnosticate.<\/p>\n<p>Determinarea unor valori concludente ale AFP \u00een serul matern nu poate fi efectuat\u0103 post amniocentez\u0103.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h2><strong>\u00a0<\/strong><strong>Bibliografie<\/strong><\/h2>\n<ol>\n<li>Gkogkos P, Androutsopoulos G, Vassilakos P, Panayiotakis G, Kourounis G, Decavalas G(2008). Mid-trimester maternal serum AFP levels in predicting adverse pregnancy outcome. Clin Exp Obstet Gynecol. 35(3):208-10.<\/li>\n<li>Bartkute, K., Balsyte, D., Wisser, J., &amp; Kurmanavicius, J. (2017). Pregnancy outcomes regarding maternal serum AFP value in second trimester screening. Journal of perinatal medicine, 45(7), 817\u2013820. <a href=\"https:\/\/doi.org\/10.1515\/jpm-2016-0101\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">https:\/\/doi.org\/10.1515\/jpm-2016-0101<\/a><\/li>\n<li>Christensen RL, Rea MR, Kessler G, et al (1986): Implementation of a screening program for diagnosing open neural tube defects: selection, evaluation, and utilization of alpha-fetoprotein methodology. Clin Chem;32:1812-1817<\/li>\n<li>American College of Obstetricians and Gynecologists: Practice Bulletin No. 163: Screening for Fetal Aneuploidy. Obstet Gynecol 2016 May;127(5):e123-137<\/li>\n<li>Sharony R, Dayan D, Kidron D, Manor M, Berkovitz A, Biron-Shental T, Maymon R (2016). Is the ratio of maternal serum to amniotic fluid AFP superior to serum levels as a predictor of pregnancy complications? Arch Gynecol Obstet.;293(4):767-70.<\/li>\n<li>\u00d6zt\u00fcrk H, Erkaya S, Alt\u0131nba\u015f S, Karada\u011f B, Vanl\u0131 Tonyal\u0131 N, \u00d6zkan D (2014). The role of unexplained high serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in the second trimester to determine poor obstetric outcomes. Turk J Obstet Gynecol.;11(3):142-147. [PMC free article]<\/li>\n<li>Rood K, Stiller R (2013). Hereditary persistence of alpha-fetoprotein: a rare cause for unexplained alpha-fetoprotein elevations in pregnancy. Conn Med.;77(1):43-5.<\/li>\n<li>Zhang J, Lambert-Messerlian G, Palomaki GE, Canick JA (2011): Impact of smoking on maternal serum markers and prenatal screening in the first and second trimesters. Prenat Diagn;31(6):583-588<\/li>\n<li>Yarbrough ML, Stout M, Gronowski AM (2018): Ch 69 Pregnancy and Its Disorders. In Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Sixth edition. Edited by N Rafai, AR Horvath, CT Wittwer. Elsevier , pp 1655-1696<\/li>\n<li>10.Mayo Clinic. Mayo Medical Laboratories. Test Catalog. [on-line]: <a href=\"https:\/\/www.neurologie-pediatrica.ro\/2020\/07\/22\/defectele_de_tub_neural\/\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">https:\/\/www.neurologie-pediatrica.ro\/2020\/07\/22\/defectele_de_tub_neural\/<\/a><\/li>\n<\/ol>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Informa\u021bii generale AFP ( Alfa-feto proteina ) \u2013 Marker sarcina\/Triplu test Determinarea AFP serice este recomandat\u0103 \u00een screening prenatal pentru eviden\u021bierea defectelor de \u00eenchidere a tubului neural (exclusiv alfa-fetoproteina), trisomia 21 (alfa-fetoprotein\u0103 impreuna cu gonadotropin\u0103 corionic\u0103 umana- hGH, estriol liber ) \u0219i trisomia 18 (alfa-fetoprotein\u0103, gonadotropin\u0103 corionic\u0103 uman\u0103-hGH \u0219i estriol liber). Alfa-fetoproteina (AFP) este o [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[36,72],"product_tag":[],"class_list":["post-219","product","type-product","status-publish","product_cat-markeri-endochrini","product_cat-markeri-pentru-sarcina-normala-patologica","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/219","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=219"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=219"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=219"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=219"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}