It appears that the proper note has been struck in the second sentence of Dr Milunsky's letter, which acknowledges our detailing of prenatal diagnosis. In our opinion, there is a generalized deficiency in the reporting of details of diagnosis for neural tube defects in the United States. With this deficiency, the very promising use of the α-fetoprotein assay in a specific clinical protocol is becoming greatly endangered.The 1.2% false-positive diagnosis rate reported by those at the Shriver Center1 is unacceptable to families who have already experienced the tragedy of having a child with a neural tube defect. The emphasis of our report and subsequent work2 has always focused on a first-hand team approach to the diagnosis of neural tube defects. By using this comprehensive approach, we have now evaluated more than 150 high-risk families against a background experience of more than 3,000 pregnancies. Within this
Macri JN, Weiss RR. Prenatal Diagnosis of Neural Tube Defects-Reply. JAMA. 1977;237(17):1824. doi:10.1001/jama.1977.03270440014003
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