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  • 1
    Electronic Resource
    Electronic Resource
    ANTENATAL SCREENING IN OXFORD FOR FETAL NEURAL TUBE DEFECTS (1979)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 86 (1979), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Between May 1975 and the end of 1977, 6443 antenatal patients were screened mainly between 16 and 22 weeks of pregnancy for neural tube defects (NTDs) at the John Radcliffe Hospital, Oxford, by maternal serum alpha-fetoprotein (AFP) measurement; a take-up of 72 per cent. Seventeen out of 18 (94 per cent) patients with open NTD pregnancies (9 out of 9 with anencephaly and 8 out of 9 with open spina bifida) had positive screening tests, and all except one were offered and accepted a termination of pregnancy. Two hundred and forty-five (3.8 per cent) patients with unaffected pregnancies also had positive screening tests, although only 1 4 per cent had an amniocentesis. Following ultrasonography, about 50 per cent of patients with unaffected pregnancies with positive screening tests were not offered an amniocentesis because they had a multiple pregnancy or their gestational age had been underestimated. The odds of having a fetus with an NTD among the women who had an amniocentesis was about 1 to 6 (1 to 11 for open spina bifida alone). Two apparently normal pregnancies were terminated. A survey of the acceptability of the screening programme among a consecutive sample of 73 patients who knew that they had a positive screening test revealed that all except one had no objection to screening in general, and 68 (93 per cent) wanted to be tested again in a future pregnancy. The approximate direct cost of the programme was £2 to £3 per patient screened, or about £l000 per NTD detected (about £2200 per open spina bifida detected).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1979.tb10574.x
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  • 2
    Electronic Resource
    Electronic Resource
    BIRTH WEIGHT OF INFANTS WITH SPINA BIFIDA CYSTICA (1980)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 87 (1980), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The mean birth weight of 189 singleton infants with spina bifida cystica (including 21 with encephalocele) was statistically significantly less than the mean birth weight of 3816 singleton infants without neural tube defects, 0·20 kg less among male infants and 0·24 kg less among female infants. Most, if not all, of this difference in birth weight was due to the spina bifida infants being light for their gestational age. The difference could not be explained by differences in parity or social class.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1980.tb05007.x
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  • 3
    Electronic Resource
    Electronic Resource
    MATERNAL SERUM ALPHA-FETOPROTEIN AND DIABETES MELLITUS (1979)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 86 (1979), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Maternal Serum Alpha-Fetoprotein (Afp) Levels Were Measured From 12 To 24 Weeks Gestation In 27 Singleton Pregnancies In Women With Insulin-Dependent Diabetes Mellitus And 90 Controls Without Diabetes Who Were Matched For Gestational Age. The Geometric Mean Afp Level Among The Diabetic Pregnancies Was 60 Per Cent Of That In The Controls, A Difference Which Was Statistically Significant (P 〈0.01). The Difference In Afp Level Between Diabetic Patients And Controls Was Most Marked In Sera Taken Before 21 Weeks Gestation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1979.tb10575.x
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  • 4
    Electronic Resource
    Electronic Resource
    THE EFFECT OF MATERNAL WEIGHT ON MATERNAL SERUM ALPHA-FETOPROTEIN LEVELS (1981)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 88 (1981), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In 902 singleton pregnancies, maternal serum alpha-fetoprotein (AFP) levels between 15 and 20 weeks of pregnancy were significantly related to maternal weight (r =−0.24, p 〈0.0001). Lighter women had on average higher AFP levels than heavier women, perhaps on account of the greater concentration of AFP in their relatively smaller volume of blood. The mean AFP level for women weighing less than 45 kg was 68 % higher than the mean level for women weighing 85 kg or more. Maternal weight was found to be an important factor which could account for false positive AFP results in antenatal screening for open neural tube defects. A policy of adjusting maternal serum AFP values according to maternal weight among women with borderline positive results could reduce the number having a diagnostic amniocentesis with only a negligible loss of detection for open spina bifida. With such a policy, using a cut-off level of 2.5 × normal median, the false positive rate in the 902 women screened would have been reduced from 2.8 % to 2.0%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1981.tb01759.x
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  • 5
    Electronic Resource
    Electronic Resource
    SMALL BIPARIETAL DIAMETER OF FETUSES WITH SPINA BIFIDA: IMPLICATIONS FOR ANTENATAL SCREENING (1980)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 87 (1980), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The biparietal diameter of 20 fetuses with spina bifida was measured during pregnancy by ultrasound scanning, mainly in the second trimester. The mean result was 0.83 cm smaller than the value based on 186 unaffected pregnancies at the same gestational ages (P〈0.001), suggesting that spina bifida fetuses are growth retarded. The practical consequence of this finding is that the routine use of ultrasound in pregnancy will increase the sensitivity of AFP screening for open spina bifida at 16 to 18 weeks gestation from 79 per cent as estimated by the UK Collaborative AFP Study to about 90 per cent or more.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1980.tb04522.x
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  • 6
    Electronic Resource
    Electronic Resource
    Effect of estimating gestational age by ultrasound cephalometry on the specificity of α-fetoprotein screening for open neural-tube defects (1982)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. A total of 1268 women had a maternal serum α-fetoprotein (AFP) screening test for open neural-tube defects between 15 and 22 weeks gestation and a routine ultrasound examination at their first antenatal visit. All had a singleton infant without a neural-tube defect. AFP values were expressed as multiples of the normal median at the relevant gestational age (MoM). The percentage of women with raised maternal serum AFP levels was less when gestation was estimated by the fetal biparietal diameter (BPD) than when the time since the first day of the last menstrual period (LMP) was used; 1.8% compared with 2.3% at a serum AFP cut-off level of 2.5 MoM. Different ultrasound policies were compared for their effect on AFP screening and the best was found to be routine BPD measurement used together with a higher cut-off level than usual. For example, using a cut-off level of 3.0 MoM the detection rate for open spina bifida at 16–18 weeks gestation would be about 88% and the proportion of unaffected singleton pregnancies with raised levels only 0.9%. These results are materially better than those achieved by a policy of scanning only those women with a raised AFP level (79% and 1.4% respectively with a more conventional cut-off level of 2.5 MoM) or, in addition, scanning those with doubtful gestational ages (82% and 1.7% respectively with a cut-off level of 2.5 MoM).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1982.tb04663.x
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  • 7
    Electronic Resource
    Electronic Resource
    MATERNAL SERUM ALPHA-FETOPROTEIN AND BIRTH WEIGHT (1980)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 87 (1980), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Maternal serum alpha-fetoprotein (AFP) levels between 16 and 18 weeks of pregnancy were studied in relation to birth weight among 4198 singleton pregnancies resulting in a liveborn or stillborn infant without a neural tube defect. The highest mean birth weight (3365 g) was found among infants born to women with AFP values in the range 0.50 to 0.74 times the normal median for the relevant week of gestation. As the AFP decreased from this level to less than 0.25 times the median, the birth weight decreased by 193 g and the proportion of infants weighing 2500 g or less increased from 4 per cent to 11 per cent. As the AFP level increased from 0.50 to 0.74 times the median to 3.0 times the median or greater, the birth weight decreased by 371 g and the proportion of infants weighing 2500 g or less increased from 4 per cent to 22 per cent. The negative association was the more important of the two since the magnitude was greater and it affected 92 per cent of pregnancies. The positive association among women with low AFP levels was substantially reduced when the analysis was restricted to women who had spontaneous labours. It seems that this minor positive association arises mainly because women in whom gestation is over-estimated tend to have both a low AFP and, later, an apparently prolonged pregnancy leading to the elective delivery of an infant who is, in fact, born early.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1980.tb04437.x
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  • 8
    Electronic Resource
    Electronic Resource
    Tobacco—the growing epidemic (1999)
    [s.l.] : Nature America Inc.
    Nature medicine 5 (1999), S. 15-17 
    Details
    ISSN: 1546-170X
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] The largest study ever undertaken to examine the health effects of tobacco finds that there are already a million deaths a year from smoking in China, and it predicts large increases in mortality over the next few decades. This pattern is likely to be repeated in other developing countries. ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/4691
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