Routine ultrasonography compared with maternal serum alpha-fetoprotein for neural tube defect screening.
Obstet Gynecol
; 106(4): 747-52, 2005 Oct.
Article
em En
| MEDLINE
| ID: mdl-16199631
ABSTRACT
OBJECTIVE:
This study was done to estimate the value of prenatal maternal serum alpha-fetoprotein (MSAFP) screening compared with that of routine ultrasonography in the diagnosis of neural tube defects (NTDs).METHODS:
An integrated database was used retrospectively to identify cases of NTDs among 219,000 consecutive pregnancy outcomes observed during a 7-year period at 40 Kaiser Permanente facilities in Northern California. We specifically examined types of NTD and the tests used to diagnose cases.RESULTS:
We identified 189 NTD cases, 102 of which had received MSAFP screening. Results of MSAFP testing were negative in 25 (25%) of these 102 cases. Without other testing, these 25 NTD diagnoses would have been missed. These included 15 (38%) of the 40 spina bifida cases screened, 6 (67%) of the 9 encephalocele cases screened, and 4 (8%) of the 53 anencephaly cases screened. Of the 186 NTD cases diagnosed prenatally, 115 (62%) were initially detected by routine ultrasonography administered during the second trimester without knowledge of MSAFP values; 69 (37%) were diagnosed by targeted ultrasonography after MSAFP screening indicated a higher risk for NTD; and 2 (1%) were diagnosed by pathology examination after miscarriage.CONCLUSION:
Compared with MSAFP performed alone for screening, routine second-trimester ultrasonography was more likely to discover an NTD.
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Base de dados:
MEDLINE
Assunto principal:
Alfa-Fetoproteínas
/
Ultrassonografia Pré-Natal
/
Doenças Fetais
/
Defeitos do Tubo Neural
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article