Registered Nurse Certified in Maternal Newborn Nursing (RNC-MNN) Practice Test

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Which condition is indicated by a high level of Alpha-fetoprotein in cases of multiple gestations?

Neural tube defect
Down syndrome
Fetal demise
Oligohydramnios

The correct answer is: Neural tube defect

A high level of Alpha-fetoprotein (AFP) in cases of multiple gestations is often indicative of neural tube defects. AFP is a protein produced by the fetus that typically enters the mother's bloodstream, and elevated levels can suggest the presence of conditions where fetal tissue is not properly closed or protected, such as spina bifida or anencephaly. In multiple pregnancies, the AFP levels can be significantly higher than in single gestations due to the presence of multiple fetuses, but it is the abnormal elevation that raises the concern for potential defects. While other conditions can influence AFP levels, neural tube defects are directly associated with increased AFP concentrations, making this the most appropriate interpretation in the context provided.