<prompt> Myelodysplasia in fetus can be best diagnosed byAFPLumbar punctureHCGUnconjugated estriol  <response>: Ans. a AFP; Ref. Robbins, Pathologic Basis of Disease, 6thpg.325Maternal serum AFP MSAFP It is a oncofoetal protein Highest level of which in foetal serum and amniotic fluid, it reaches around 13 weeks and decreases thereafter. It reaches a peak around 32 weeks. It decreases in Downs syndrome. Its increased levels are seen in Mnemonic WORMIAN- Wrong gestational age,- Open neural tube defects,- Renal anomalies,- Multiple pregnancy,- IUD,- Anterior abdominal wall defects,- Nephrotic syndrome Congenital. Ach esterase has better diagnostic value than AFP in open neural tube defects. AI 2005 Normal levels of AFP in liquor at 16th week 20 mgdL. AFP is tumor marker for HCC, Non-seminomatous GCTs and ovarian sexcord tumors like Sertoli-Leydig tumors. 