10 research outputs found
Method for cohort and nested case-control studies: the prevalence, timing and effectiveness of obstetric ultrasound, Victoria 1991–1992
Pulse oximetry screening for critical congenital heart disease: a comparative study of cohorts over 11 years
A population-based study of the prenatal diagnosis of congenital malformation over 16 years
Diagnosis and outcome of fetal lower urinary tract obstruction in the northern region of England
A six year study of the antenatal detection of fetal abnormality in six Scottish health boards
Comparative trends in cause-specific fetal and neonatal mortality in twin and singleton births in the North of England, 1982-1994
The sensitivity of ultrasound and serum alpha-fetoprotein in population-based antenatal screening for neural tube defects, South Australia 1986-1991
ObjectiveTo determine the sensitivity of antenatal screening methods for neural tube defects in population-based screening in South Australia in 1986-1991, and whether ultrasound can replace serum alpha-fetoprotein screening in terms of achieving an equivalent level of sensitivity.Design and settingAscertainment of all births and terminations of pregnancy with neural tube defects from multiple sources for 1986-1991 in South Australia. Serum and amniotic fluid alpha-fetoprotein results were obtained from the only laboratory performing the tests as a Statewide antenatal screening programme, and information on ultrasound screening from case notifications, hospital case records and medical practitioners who cared for the women.SubjectsAll 243 births and terminations of pregnancy with neural tube defects in South Australia in 1986-1991.Main outcome measuresThe sensitivity of individual screening methods and of all methods used, particularly for spina bifida.ResultsFor pregnancies with neural tube defects screened by any method (serum alpha-fetoprotein, ultrasound or amniocentesis), 86% sensitivity was achieved. Ultrasound screening for anencephaly achieved 100% sensitivity even in low risk pregnancies, compared with 92% for serum alpha-fetoprotein. For spina bifida, the sensitivity of ultrasound screening increased with the level of risk in pregnancy: it was 60% in low risk pregnancies, which was equivalent to that of serum alpha-fetoprotein screening (64%); 89% in high risk pregnancies and 100% for women referred for confirmation of a suspected spina bifida by another ultrasonographer (chi 1(2) for trend = 23.49, P ConclusionsAntenatal screening for neural tube defects in South Australia achieved a higher level of sensitivity with the maternal serum alpha-fetoprotein programme in place. We conclude that the serum screening programme should continue in South Australia pending a significant improvement in the sensitivity of routine ultrasound screening for spina bifida