|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Routine Ultrasound Finds More NTD's Than MSAFPFrom: art fougner, md (evsono@pipeline.com)Sat Oct 1 15:41:09 2005
Another of my personal biases that seems to be borne out in this month's Green Journal... Routine Ultrasonography Compared With Maternal Serum Alpha-fetoprotein for Neural Tube Defect Screening Carol T. Norem, MS1, Edgar J. Schoen, MD1, David L. Walton, MD2, Robyn C. Krieger, MS1, Jennifer O'Keefe, RN, MPH1, Trinh T. To1 and G. Thomas Ray, MBA3
>From the 1Regional Perinatal Screening Section, Department of Genetics, OBJECTIVE: This study was done to estimate the value of prenatal maternal serum alpha-fetoprotein (MSAFP) screening compared with that of routine ultrasonography in the diagnosis of neural tube defects (NTDs). METHODS: An integrated database was used retrospectively to identify cases of NTDs among 219,000 consecutive pregnancy outcomes observed during a 7-year period at 40 Kaiser Permanente facilities in Northern California. We specifically examined types of NTD and the tests used to diagnose cases. RESULTS: We identified 189 NTD cases, 102 of which had received MSAFP screening. Results of MSAFP testing were negative in 25 (25%) of these 102 cases. Without other testing, these 25 NTD diagnoses would have been missed. These included 15 (38%) of the 40 spina bifida cases screened, 6 (67%) of the 9 encephalocele cases screened, and 4 (8%) of the 53 anencephaly cases screened. Of the 186 NTD cases diagnosed prenatally, 115 (62%) were initially detected by routine ultrasonography administered during the second trimester without knowledge of MSAFP values; 69 (37%) were diagnosed by targeted ultrasonography after MSAFP screening indicated a higher risk for NTD; and 2 (1%) were diagnosed by pathology examination after miscarriage. CONCLUSION: Compared with MSAFP performed alone for screening, routine second-trimester ultrasonography was more likely to discover an NTD. Art
-- art fougner, md
|
|
Return to
|
Mail a New Message to the Forum: ultrasound@obgyn.net Forum Administrator: terry.dubose@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:36:39 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.