Morrow R J, McNay M B, Whittle M J
Department of Obstetrics and Gynecology, Queen Mother's Hospital, Glasgow, Scotland.
Obstet Gynecol. 1991 Dec;78(6):1055-7.
We conducted this study to determine the accuracy of ultrasound in the prenatal diagnosis of neural tube defects in women with elevated maternal serum alpha-fetoprotein (MSAFP). Among 905 pregnancies, 49 neural tube defects were correctly diagnosed by ultrasound alone; one was not. Ultrasound scanning had 98% sensitivity and 100% specificity for the detection of neural tube defects. The predictive value of a positive ultrasound diagnosis was 100% and of a negative ultrasound 99.9% for neural tube defects. Forty-three other structural abnormalities were also detected in patients with elevated MSAFP, including 19 abdominal wall defects, seven chromosomal abnormalities, five urinary tract abnormalities, one cardiac abnormality, and 11 others. Two chromosomal abnormalities were not detected. We suggest that ultrasound can be used reliably to detect neural tube defects, thereby avoiding the risks of amniocentesis.
我们开展这项研究，以确定超声对母血清甲胎蛋白（MSAFP）升高的孕妇进行神经管缺陷产前诊断的准确性。在905例妊娠中，49例神经管缺陷仅通过超声被正确诊断；1例未被诊断出。超声扫描检测神经管缺陷的敏感性为98%，特异性为100%。超声诊断阳性对神经管缺陷的预测值为100%，阴性为99.9%。在MSAFP升高的患者中还检测出43例其他结构异常，包括19例腹壁缺陷、7例染色体异常、5例泌尿系统异常、1例心脏异常和11例其他异常。2例染色体异常未被检测出。我们建议超声可可靠地用于检测神经管缺陷，从而避免羊膜穿刺术的风险。
