Abstract
After the initial reports of the association of fetal trisomy 21 with low maternal serum alpha fetoprotein (MSAFP) levels in retrospective studies in 1984, we began using low MSAFP levels as a means of screening for an increased risk of Down syndrome using reagents from Clinical Assays. In 1985, a total of 4929 women were screened, of whom 312 (6.3%) had an initial low MSAFP levels. Of these women, 217 (70%) had levels below the level of reliability of the assay and all but 33 had normal levels on repeat 1-2 weeks later. None of these women had a fetus or infant with trisomy 21 by amniocentesis or at birth. Ninety-five women (1.9%) had levels below half the median. Of these women, 12 had persistently low levels on repeat. A total of 21 amniocenteses were done in this group. Three fetuses with trisomy 21 and one fetus with trisomy 18 were detected, a rate of 7.1% fetal trisomy among those women who had amniocentesis for low MSAFP levels. No cases of trisomy 21 were missed. Thus far in 1986, over 10,000 women have been screened. The rate of fetal trisomy in amniotic fluid is about 3%. One infant with trisomy 21 is known to have been missed.
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Greenberg, F., Garza, J., Weyland, B. et al. PROSPECTIVE MSAFP SCREENING FOR DOWN SYNDROME: THE BAYLOR EXPERIENCE. Pediatr Res 21 (Suppl 4), 227 (1987). https://doi.org/10.1203/00006450-198704010-00366
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DOI: https://doi.org/10.1203/00006450-198704010-00366