Document Detail

Elevated levels of amniotic fluid alpha-fetoprotein: sonographic evaluation.
MedLine Citation:
PMID:  7685529     Owner:  NLM     Status:  MEDLINE    
From 1978 to 1990, 263 fetuses with an elevated level of amniotic fluid alpha-fetoprotein (AF-AFP) (> 2.0 multiples of the median) were examined with targeted fetal sonography. All cases of AF-AFP elevation among 22,355 genetic amniocenteses were represented. Sonography correctly showed 32 open neural-tube defects, including 20 myelomeningoceles, and depicted 94% (63 of 67) of the anomalous fetuses. Two of five anomalous fetuses with normal sonograms, however, had extremely high AF-AFP levels leading to prospectively correct diagnoses of congenital nephrosis. Therefore, programmatically, 97% (65 of 67) of the anomalous fetuses were recognized. The three programmatic misdiagnoses were all detected in the neonatal period and surgically corrected; subsequent development was normal. The combination of an elevated AF-AFP level and a detailed sonogram allowed distinction between a normal and an anomalous fetus in 99% of cases. When elevated levels are noted, AF-AFP analysis followed by detailed sonography is highly successful for the detection and characterization of anomalous fetuses and the recognition of normal fetuses with physiologic increases of this protein in the amniotic fluid.
M Robbin; R A Filly; S Fell; R B Goldstein; P W Callen; J D Goldberg; M S Golbus
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  188     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-07-13     Completed Date:  1993-07-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  165-9     Citation Subset:  AIM; IM    
Department of Radiology, University of California, San Francisco 94143-0628.
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MeSH Terms
Acetylcholinesterase / analysis
Amniotic Fluid / chemistry*
Congenital Abnormalities / diagnosis*
False Negative Reactions
Neural Tube Defects / diagnosis
Predictive Value of Tests
Pregnancy / blood
Sensitivity and Specificity
Ultrasonography, Prenatal* / methods
alpha-Fetoproteins / analysis*
Reg. No./Substance:
0/alpha-Fetoproteins; EC
Comment In:
Radiology. 1993 Jul;188(1):17-8   [PMID:  7685530 ]

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