Skip Navigation LinksHome > August 1982 - Volume 60 - Issue 2 > Ultrasound and Amniotic Fluid Alpha-Fetoprotein in the Prena...
Obstetrics & Gynecology:
Original Article: PDF Only

Ultrasound and Amniotic Fluid Alpha-Fetoprotein in the Prenatal Diagnosis of Spina Bifida.

ALLEN, LYNN C. PhD; DORAN, TERENCE A. MD; MISKIN, MURRAY MD; RUDD, NOREEN L. MD; BENZIE, RONALD J. MD; SHEFFIELD, LESLIE J. MD

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Abstract

Amniotic fluid alpha-fetoprotein (AFP) assays and detailed ultrasound examinations were performed in 376 prenatal patients at risk for a neural tube defect (high-risk group). In addition, 2436 patients who underwent amniocentesis for other indications underwent preamniocentesis ultrasound screening and amniotic fluid AFP assays (low-risk group). There were 10 neural tube defects in the high-risk group (7 open and 3 closed) and 3 in the low-risk group (all open). Two of the 3 closed defects were detected prenatally. The predictive value of an elevated AFP level for ah abnormal fetus was much higher in the high-risk (6 of 6,100%) than in the low-risk group (1 of 6,17%). When both ultrasound and AFP assay results were normal, the chance of a normal outcome was very high in both the high- and low-risk groups (99.7 and 100%, respectively). It was of particular interest that in the low-risk group, the likelihood of an abnormal outcome in women with elevated AFP and a normal ultrasonogram was low (0 of 5).

(C) 1982 The American College of Obstetricians and Gynecologists

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