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The development of action lines in an Australian maternal serum alphafetoprotein screening service for neural tube

T Nicolas1, E M Nicholls, R D Robertson

  • 1Department of Obstetrics and Gynaecology, Royal North Shore Hospital of Sydney, St. Leonards, NSW.

A retrospective study covering the period from January 1, 1980 up to June 30, 1982 was conducted, producing the first definitive normal range for maternal serum alphafetoprotein from the Royal North Shore Hospital in Sydney. The normal range established is based on and applicable to the pregnant women tested at this NSW laboratory. Maternal serum alphafetoprotein levels had been determined by radioimmunoassay for 3,182 pregnancies between 13 and 20 weeks' gestation. Five anencephalics and 2 open spina bifidas were noted in the study. Only one of these abnormalities (spina bifida) was associated with maternal serum alphafetoprotein levels within the normal range, the remainder all having elevated levels. Low false positive and false negative rates of 1.16% and 0.03% respectively were obtained in this study.

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