Maternal serum alpha-fetoprotein (MSAFP)screening indicates an elevated level.MSAFP screening is repeated and again is reported as higher than normal.What would be the next step in the assessment sequence to determine the well-being of the fetus?

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If MSAFP findings are abnormal,follow-up procedures include genetic counseling for families with a history of neural tube defect,repeated MSAFP screening,ultrasound examination,and possibly amniocentesis.Indications for use of PUBS include prenatal diagnosis of inherited blood disorders,karyotyping of malformed fetuses,detection of fetal infection,determination of the acid-base status of fetuses with intrauterine growth restriction,and assessment and treatment of isoimmunization and thrombocytopenia in the fetus.BPP is a method of assessing fetal well-being in the third trimester.Before amniocentesis is considered,the client first would have an ultrasound for direct visualization of the fetus.

Maternal Serum Alpha-Fetoprotein (MSAFP)screening Indicates an Elevated Level