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Some problems of alpha-fetoprotein screening

M J Bennett, K Blau, R D Johnson

    Lancet (London, England)
    |December 16, 1978
    PubMed
    Summary
    This summary is machine-generated.

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    This study evaluated a neural-tube defect screening program using serum-alpha-fetoprotein (AFP) testing. While effective, ultrasound assessment of gestational age is crucial for accurate AFP interpretation and to minimize false positives and negatives.

    Area of Science:

    • Medical Screening
    • Prenatal Diagnostics
    • Biochemistry

    Background:

    • Neural-tube defects (NTDs) are significant congenital abnormalities.
    • Routine screening programs aim to detect NTDs early in pregnancy.
    • Serum-alpha-fetoprotein (AFP) is a key biomarker for NTD screening.

    Purpose of the Study:

    • To evaluate the effectiveness of a routine screening program for NTDs using serum-alpha-fetoprotein (AFP).
    • To assess the accuracy of AFP screening, including false negatives and false positives.
    • To investigate the impact of gestational age assessment on screening accuracy.

    Main Methods:

    • Over 6000 women underwent serum-AFP measurement as part of a two-year screening program.
    • Women with elevated serum-AFP levels underwent ultrasound-guided amniocentesis.

    Related Experiment Videos

  • Detection rates were evaluated by recording NTDs at birth and analyzing abortuses.

    • Main Results:

    • 16 amniotic fluid AFP levels were abnormal, with one false positive.
    • Two cases of closed NTDs were missed at the serum-AFP stage.
    • Ultrasound assessment of gestational age significantly impacted the interpretation of serum-AFP results.

    Conclusions:

    • The screening program demonstrated a favorable detection rate for NTDs.
    • Accurate gestational age assessment via ultrasound is critical for interpreting serum-AFP levels.
    • Potential risks, including fetal loss from amniocentesis, must be considered alongside screening benefits.