| Autor: |
Evans MI, Belsky RL, Clementino NA, Shlagor P, Brieger G, Koppitch FC 3rd, Syner FN, Rodriguez SE, Sokol RJ |
| Jazyk: |
angličtina |
| Zdroj: |
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 1987 Jun; Vol. 156 (6), pp. 1441-9. |
| DOI: |
10.1016/0002-9378(87)90014-7 |
| Abstrakt: |
Expansion of the availability of tertiary level services beyond major medical centers has proved to be a major problem in health care delivery. Routine maternal serum alpha-fetoprotein screening for neural tube defects, and now also for aneuploidy, is a classic example in which there has been a schism between the clinical expertise to manage such a program within a tertiary level reproductive genetics center and the ability to reach patients in regions that are not routinely accessible to the tertiary center. To address this problem we have established a collaborative university-commercial laboratory statewide maternal serum alpha-fetoprotein program that we believe can serve as a model for others. In the first 4 months since its implementation, the program volume has increased tenfold. The detection frequency of neural tube defects has been consistent with that of other programs (1/1690). Three aneuploid karyotypes were found in amniotic fluid of 118 women less than 30 years old who underwent genetic amniocentesis because of a low maternal serum alpha-fetoprotein value. Thus we conclude that: the establishment of a joint university-commercial maternal serum alpha-fetoprotein program may provide a successful model for efficient tertiary center outreach, assessment of our data suggests that a population at high risk for abnormal fetuses can be identified among patients not generally considered at high risk, low maternal serum alpha-fetoprotein values may likely be a more important public health measure than high ones. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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