In a pregnant woman with elevated serum AFP at 12 weeks gestation, what is the appropriate follow-up?

In the context of elevated serum alpha-fetoprotein (AFP) levels in a pregnant woman, repeating the serum AFP in 2 weeks is crucial for appropriate assessment. Elevated AFP can be indicative of various conditions, including multiple gestations, fetal abnormalities, or even false positives stemming from laboratory variability.

By repeating the serum AFP after a brief interval, healthcare providers can obtain a clearer picture of the situation. This follow-up allows for the monitoring of the AFP trend, as levels can change over time. If AFP levels consistently remain elevated, additional diagnostic evaluations may be warranted to investigate the underlying cause, such as an ultrasound for fetal assessment or considering further tests.

The other options lack the strategic follow-up necessary for accurate diagnosis and management. For example, recommending an AFP assay on amniotic fluid could be premature without first confirming elevated levels and establishing a pattern. Utilizing the same sample for another method may not provide different insights and would not address whether the initial elevation was a processing error or a true anomaly. Lastly, repeating the AFP using the same method does not account for the need to observe trends over time, which is critical in determining the clinical significance of the initial elevated levels.