Ward R H, Fairweather D V, Whyley G A, Shirley I M, Lucas M
Prenat Diagn. 1981 Apr;1(2):91-101. doi: 10.1002/pd.1970010203.
Estimation of alpha-fetoprotein (A.F.P.) in maternal serum was used as a screening method for the detection of fetal neural tube defect (N.T.D.) in 7315 women over a four year period. Of these, 5668 pregnancies were tested between 15 and 21 weeks. Action was advised in 129 patients (2.3 per cent). In 74 patients, the only action required was reviewing the notes, including the report of any ultrasound examination, and repeating the blood A.F.P. Detailed ultrasound including scanning the fetal spine was requested in 47 patients and amniocentesis was advised in 19 of these (0.33 per cent). In practice the incidence of amniocentesis was 0.28 per cent as three patients declined our advise. The programme gave detection rates between 15 and 21 weeks of 100 per cent and 75 per cent respectively for anencephaly and open spina bifida. A high fetal mortality was associated with persistently elevated blood A.F.P. levels whether amniocentesis was performed or not.
在四年时间里，对7315名孕妇采用检测母血清甲胎蛋白（A.F.P.）的方法筛查胎儿神经管缺陷（N.T.D.）。其中，5668例妊娠在孕15至21周时接受了检测。对129例患者（2.3%）提出了处理建议。在74例患者中，唯一需要做的是查阅病历，包括任何超声检查报告，并复查血A.F.P.。对47例患者要求进行包括扫描胎儿脊柱在内的详细超声检查，并对其中19例（0.33%）建议行羊膜穿刺术。实际上，羊膜穿刺术的发生率为0.28%，因为有3例患者拒绝了我们的建议。该方案在孕15至21周时对无脑儿和开放性脊柱裂的检出率分别为100%和75%。无论是否进行羊膜穿刺术，胎儿死亡率高均与血A.F.P.水平持续升高有关。
