<prompt> Which of the following in maternal serum indicate open neural tube defect: March 2011Increased folic acid levelsIncreased Alpha fetoprotein levelsDecreased Alpha fetoprotein levelsDecreased beta-HCG  <response>: Ans. B: increased Alpha fetoprotein levels MSAFP level is elevated in 1 wrong gestational age, 2 open neural tube defect NTDs, 3 multiple pregnancies, Rh isoimmunisation 4 IUFD, 5 anterior abdominal wall defects and 6 renal anomalies Risk factors for NTD: Family history of neural tube defects Maternal diabetes insufficient folic acid intake during pregnance Maternal intake of anti-epileptics 