Document Detail


Pregnancy outcomes after increasing maternal serum alpha-fetoprotein levels.
MedLine Citation:
PMID:  2471946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Five hundred sixty women among 35,787 screened had an initial maternal serum alpha-fetoprotein (MSAFP) of 2.5 or more multiples of the median. They were divided into three groups: group 1, 2.5-2.9; group 2, 3.0-3.9; and group 3, over 4.0 multiples of the median. These groupings determined the relationship to adverse pregnancy outcome, defined as fetal death, fetus with significant anomalies, and prematurity/growth retardation. The overall risk of adverse outcome after an initial elevation was 38%, after excluding pregnancies with incorrect dates or multiple gestations with levels below 4.5 multiples of the median: 27, 39, and 45% in groups 1, 2, and 3, respectively. This risk rose to 86% for levels over 6.0 multiples of the median. There was a significant positive correlation between abnormalities and death detected with ultrasound and amniocentesis and those indicated by increasing MSAFP levels: 10, 20, and 31% in groups 1, 2, and 3, respectively. After normal ultrasound and amniocentesis studies, there was a trend toward increasing risks for fetal death after 20 weeks between groups 2 and 3 (5 and 11%), but not for growth retardation/prematurity (12, 17, and 13%). After an elevated MSAFP, the overall risk of a late pregnancy complication after normal ultrasound and amniocentesis was 22%: 19, 23, and 25% in groups 1, 2, and 3, respectively. This figure increased to 67% for levels above 6.0 multiples of the median.
Authors:
L Robinson; P Grau; B F Crandall
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  74     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-07-21     Completed Date:  1989-07-21     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  17-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Psychiatry, University of California, Los Angeles.
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MeSH Terms
Descriptor/Qualifier:
Amniocentesis
Congenital Abnormalities / diagnosis,  epidemiology
Female
Fetal Death / epidemiology
Humans
Infant, Low Birth Weight
Infant, Newborn
Predictive Value of Tests
Pregnancy
Pregnancy Outcome*
Prenatal Care / methods*
Prenatal Diagnosis
Risk
Ultrasonography
alpha-Fetoproteins / metabolism*
Grant Support
ID/Acronym/Agency:
HD 07032/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/alpha-Fetoproteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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