Dashe Jodi S, Twickler Diane M, Santos-Ramos Rigoberto, McIntire Donald D, Ramus Ronald M
Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX TX 75235-9032, USA.
Am J Obstet Gynecol. 2006 Dec;195(6):1623-8. doi: 10.1016/j.ajog.2006.03.097. Epub 2006 Jun 12.
The purpose of this study was to evaluate neural tube defect (NTD) detection according to whether serum alpha-fetoprotein (AFP) screening or standard ultrasound are performed.
Prenatal and neonatal datasets were reviewed to identify pregnancies with NTDs from 1 institution between January 2000 and December 2003. AFP screening was offered < 21 weeks and considered elevated if > or = 2.50 multiples of the median. Standard ultrasound was performed for specific indications in low-risk pregnancies.
There were 66 NTDs, 1 per 950 deliveries. AFP sensitivity was 65%. If the gestational age used for AFP calculation was confirmed with ultrasound, sensitivity improved to 86%. The sensitivity of standard ultrasound was 100%, P < .001 compared with AFP screening. NTDs detected with standard ultrasound were identified later in gestation, as examinations were performed for other indications.
Standard ultrasound improved NTD detection over AFP screening alone, by improving AFP test sensitivity and identifying NTDs in low-risk pregnancies.
本研究旨在根据是否进行血清甲胎蛋白（AFP）筛查或标准超声检查来评估神经管缺陷（NTD）的检测情况。
回顾了产前和新生儿数据集，以确定2000年1月至2003年12月期间1家机构中患有NTD的妊娠情况。AFP筛查在孕21周之前进行，若AFP水平大于或等于中位数的2.50倍则视为升高。对低风险妊娠的特定指征进行标准超声检查。
共有66例NTD，每950例分娩中有1例。AFP筛查的敏感度为65%。如果用于AFP计算的孕周经超声确认，则敏感度提高到86%。标准超声的敏感度为100%，与AFP筛查相比，P < 0.001。通过标准超声检测出的NTD在妊娠后期才得以确认，因为这些检查是针对其他指征进行的。
与单独的AFP筛查相比，标准超声检查通过提高AFP检测敏感度以及识别低风险妊娠中的NTD，改善了NTD的检测情况。
