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Four years' experience of maternal alpha‐fetoprotein screening and its effect on the pattern of antenatal care
Author(s) -
Ward R. H. T.,
Fairweather D. V. I.,
Whyley G. A.,
Shirley I. M.,
Lucas M.
Publication year - 1981
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.1970010203
Subject(s) - medicine , obstetrics , alpha (finance) , alpha fetoprotein , prenatal care , pregnancy , biology , nursing , genetics , patient satisfaction , construct validity , hepatocellular carcinoma
Estimation of alpha‐fetoprotein (A.F.P.) in maternal serum was used as a screening method for the detection of fetal neural tube defect (N.T.D.) in 7315 women over a four year period. Of these, 5668 pregnancies were tested between 15 and 21 weeks. Action was advised in 129 patients (2·3 per cent). In 74 patients, the only action required was reviewing the notes, including the report of any ultrasound examination, and repeating the blood A.F.P. Detailed ultrasound including scanning the fetal spine was requested in 47 patients and amniocentesis was advised in 19 of these (0·33 per cent). In practice the incidence of amniocentesis was 0·28 per cent as three patients declined our advice. The programme gave detection rates between 15 and 21 weeks of 100 per cent and 75 per cent respectively for anencephaly and open spina bifida. A high fetal mortality was associated with persistently elevated blood A.F.P. levels whether amniocentesis was performed or not.