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Related Experiment Videos

Selective use of maternal serum testing.

I Montague1, R Fox

  • 1Directorate of Obstetrics, Gynaecology and Paediatrics, Taunton and Somerset Hospital, UK.

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
|October 30, 2004
PubMed
Summary

Maternal serum screening for fetal abnormalities can be offered in parts. Women declining invasive testing for trisomy 21 (T21) may accept screening for neural tube defects (NTDs) alone.

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Area of Science:

  • Maternal-fetal medicine
  • Prenatal screening
  • Obstetrics

Background:

  • Maternal serum testing screens for trisomy 21 (T21) and neural tube defects (NTDs).
  • Diagnostic follow-up for T21 involves amniocentesis, while NTDs are diagnosed via ultrasound.
  • Some women decline comprehensive screening due to aversion to invasive procedures or termination of pregnancy.

Purpose of the Study:

  • To evaluate the impact of offering selective maternal serum screening.
  • To determine if offering AFP measurement alone increases uptake in women declining comprehensive testing.

Main Methods:

  • Retrospective case-note review of 231 new bookings.
  • Identified 61 women who initially declined the double test (AFP/hCG).
  • Offered AFP measurement alone to these women.

Main Results:

  • Of 61 women declining the double test, 23 cited amniocentesis aversion, 29 termination concerns.
  • 21 out of 61 women (34%) accepted AFP measurement when offered alone.
  • This suggests a viable alternative for women with specific concerns.

Conclusions:

  • Maternal serum screening is not monolithic; components can be offered separately.
  • In units with limited ultrasound, offering AFP alone may improve screening uptake.
  • Clinicians should consider tailored approaches for antenatal screening.

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