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| Application of Maternal Serum AFP Combined with Ultrasonography in the Screening of Fetal Neural Tube Defects at 16-27 Weeks of Gestation |
| DENG Yong, GU Yuping, LI Lifa, LENG Jun, LIU Ting |
| Yichun Yuanzhou Modern Hospital, Yichun 336000, China |
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Abstract Objective: To explore the clinical value of maternal serum alpha fetoprotein (AFP) combined with ultrasound screening for fetal neural tube defects in the second trimester of pregnancy, so as to provide reference for clinical diagnosis and treatment of fetal neural tube defects. Method: A prospective study was conducted on pregnant women who were screened for neural tube defects in the second trimester (16-27 weeks of gestation) in Yichun Yuanzhou Modern Hospital from January 2019 to January 2022. All of them underwent ultrasound examination, and the maternal serum AFP level was detected at the same time. The screening was confirmed by autopsy after induction of labor or follow-up after birth for fetuses with neural tube abnormalities, and confirmed by telephone or outpatient follow-up for healthy fetuses. The results of induction of labor or follow-up after birth were the "gold standard", the pregnant women were divided into positive group and negative group, and the maternal serum AFP levels of the two groups were compared. The results of ultrasound examination and imaging manifestations were analyzed. At the same time, the relationship between the results of ultrasound examination and serum AFP level was analyzed, the value of maternal serum AFP combined with ultrasound in screening fetal neural tube defects in the second trimester was analyzed. Result: A total of 7 694 pregnant women were screened in this study, of which 12 were lost to follow-up. Finally, 7 682 pregnant women were included in this study. A total of 19 fetuses were diagnosed with neural tube defects, accounting for 2.47‰ (19/7 682). Ultrasound correctly diagnosed fetal neural tube malformation in 17 cases, including 7 cases of anencephaly, 1 case of open brain malformation, 1 case of encephalocele, and 8 cases of spina bifida. The maternal serum AFP level of positive group was higher than that of negative group (P<0.05). Point-biserial correlation analysis showed that the positive rate of ultrasonography was positively correlated with maternal serum AFP (r=0.532, P=0.019). The area under the curve (AUC) of maternal serum AFP combined with ultrasound in screening fetal neural tube defects in the second trimester was the largest, 0.910, and the sensitivity and specificity were 89.50% and 98.80% respectively. Conclusion: Maternal serum AFP combined with ultrasound has certain value in screening neural tube defects in the second trimester of pregnancy.
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Received: 14 October 2022
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