Re: Triscreen question - NTDs

From: art fougner, md (evsono@pipeline.com)
Fri May 14 19:49:06 1999


See Nadel et al - Absence of need for amniocentesis in patients with elevated levels of maternal serum alpha-fetoprotein and normal ultrasonographic examinations NEJM Aug 1990. in fact, ultrasound is a much better test than AFP for NTD, save for those patients who image poorly, thanks to our colleagues Nicolaides and Campbell who gave us the lemon and banana signs. The last spina bifida we encountered had a nl serum screen - her dates were off!

Art

"Of course, that's just my opinion. I could be wrong." - Dennis Miller

At Fri, 14 May 1999, DoctorJoe@aol.com wrote: >
>In a message dated 5/14/99 6:08:53 AM, mgnewman@flash.net writes:
>
><< Peter put what I wanted to say much more succinctly than I could, and what
>he says is the way to go about it, IMHO. Further, I still recommend Triple
>screen for almost all patients as a screen for open NTD...sonography is
>good, but it is helpful to narrow down those whose neural tubes/ventral
>walls/etc. are at risk. >>
>
>Okay, then what do y'all do with this:
>
>Supposed you have a "positive" triple screen or AFP and you do a very careful
>ultrasound and find NO ventral wall defects or NTDs. What do you tell the
>patient?
>
>Joe P.

--
art fougner, md
SonoScan/Genetic Sciences
forest hills, ny
evsono@pipeline.com




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