Alpha-fetoprotein detection of neural tube defects and the impact of standard ultrasound

Jodi S. Dashe, Diane M. Twickler, Rigoberto Santos-Ramos, Donald D. McIntire, Ronald M. Ramus

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objective: The purpose of this study was to evaluate neural tube defect (NTD) detection according to whether serum alpha-fetoprotein (AFP) screening or standard ultrasound are performed. Study design: Prenatal and neonatal datasets were reviewed to identify pregnancies with NTDs from 1 institution between January 2000 and December 2003. AFP screening was offered <21 weeks and considered elevated if ≥2.50 multiples of the median. Standard ultrasound was performed for specific indications in low-risk pregnancies. Results: There were 66 NTDs, 1 per 950 deliveries. AFP sensitivity was 65%. If the gestational age used for AFP calculation was confirmed with ultrasound, sensitivity improved to 86%. The sensitivity of standard ultrasound was 100%, P < .001 compared with AFP screening. NTDs detected with standard ultrasound were identified later in gestation, as examinations were performed for other indications. Conclusion: Standard ultrasound improved NTD detection over AFP screening alone, by improving AFP test sensitivity and identifying NTDs in low-risk pregnancies.

Original languageEnglish (US)
Pages (from-to)1623-1628
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Dec 1 2006


  • Neural tube defects
  • Standard ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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