Alpha feto protein levels are increased in all, EXCEPT:

MSAFP above normal is seen in multiple gestation, when there is placental abruption, as well as in a number of fetal abnormalities, such as neural tube defects including spina bifida and anencephaly, and abdominal wall defects. Other possibility is error in the date of the gestation. Mothers with Methylene tetrahydrofolate reductase genetic variant also have more frequent elevated MSAFP. Abnormally high levels were found infrequently in fetal distress and intra uterine fetal death. MSAFP below normal is associated with a smaller number of conditions, including Down syndrome and Trisomy 18.