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Related Experiment Videos

Repeat maternal serum alpha-fetoprotein testing in antenatal screening programmes for Down's syndrome.

H S Cuckle1, N J Wald, K Nanchahal

  • 1Department of Environmental and Preventive Medicine.

British Journal of Obstetrics and Gynaecology
|January 1, 1989
PubMed
Summary

Repeat maternal serum alpha-fetoprotein (AFP) testing is not recommended for Down's syndrome screening. If a second AFP test is performed, risk assessment must consider both test results for accurate Down

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Genetics
  • Prenatal Diagnostics

Background:

  • Down's syndrome screening commonly utilizes maternal age and maternal serum alpha-fetoprotein (AFP) levels.
  • Maternal serum AFP testing is typically performed between 14 and 20 weeks of gestation.
  • The utility of repeat AFP testing in Down's syndrome screening requires clarification.

Purpose of the Study:

  • To estimate the risk of Down's syndrome in pregnancies based on maternal age and one or two maternal serum AFP tests.
  • To evaluate the impact of repeat AFP testing on Down's syndrome risk assessment.
  • To provide risk estimates for counseling patients undergoing repeat AFP testing.

Main Methods:

  • Risk estimation based on published data and maternal serum AFP results from pregnancies with repeat testing.

Related Experiment Videos

  • Analysis of AFP levels (multiples of the normal median - MoM) from nine affected and 145 unaffected pregnancies.
  • Comparison of risk estimates using single versus combined results from two AFP tests.

    • Main Results:

    • Repeat AFP testing is generally not justified in Down's syndrome screening programs.
    • When a second AFP test is performed, risk estimates depend on both the first and second test results.
    • Example: A 35.5-year-old woman with initial AFP of 0.50 MoM (risk 1:172) has an increased risk to 1:216 if a second test shows 0.80 MoM, compared to 1:353 if only the second test is considered.

    Conclusions:

    • Repeat maternal serum AFP testing is not a justified component of antenatal screening for Down's syndrome.
    • If a second AFP test is conducted, both results must be incorporated for accurate individual patient risk counseling.
    • Risk estimates for Down's syndrome can be determined using maternal serum AFP results from 0.40 to 2.50 MoM across first and second tests.