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May 16, 1977

Progress in Screening for Neural Tube Defects

Author Affiliations

Nassau County Medical Center East Meadow, NY
Nassau County Department of Health Mineola, NY
Princeton Laboratory Products Company Princeton, NJ

JAMA. 1977;237(20):2187. doi:10.1001/jama.1977.03270470023006

To the Editor.—  Screening of an unselected pregnant population for neural tube defects using maternal serum αfetoprotein (AFP) represents an important step toward the prenatal diagnosis of a majority of these serious congenital anomalies. This concept has been alluded to by Macri et al (236:1251, 1976).The first such screening program in the United States has been initiated at the Nassau County Medical Center in October 1976. Normal maternal serum AFP values have now been established in more than 2,500 pregnancies.1 To date, 1,337 nonrisk pregnancies have been screened. The Table represents a summary of findings subsequent to the initial screening observation of two elevated serum AFP levels between the 15th and 20th weeks of gestation.

Report of Cases.—Case 1.—  Maternal serum was initially obtained during the 18th week of gestation from an 18-year-old primagravida with no history of birth defects. This sample contained 522 ng/ml