If a client who is 16 weeks pregnant has an elevated alpha-fetoprotein (AFP) level, the physician is likely to refer the client to further testing to determine the cause of the elevated AFP level. Elevated AFP levels can be caused by a variety of factors, including fetal open neural tube defects, ventral wall defects, placental abnormalities, epidermolysis bullosa, fetomaternal hemorrhage, and congenital nephrosis
. Therefore, the physician may order additional tests, such as an ultrasound, to check for fetal abnormalities or a test to check for congenital nephrosis. The physician may also monitor the client's blood pressure and proteinuria to check for the development of pre-eclampsia, which has been associated with elevated AFP levels in some cases
. Ultimately, the physician will determine the appropriate course of action based on the individual client's situation.