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Abstract
Prenatal screening, in this Clinical Opinion article, is defined as a population-based
search for subgroups of pregnancy that by virtue of their maternal serum α-fetoprotein
levels may be at increased risk for genetic anomalies. The identification of subgroups
at risk for (1) neural tube defects, (2) ventral wall defects, and (3) chromosomal
trisomies presents clinicians with unprecedented information and issues, including
the biomedical basis for prenatal screening, the distinction between screening and
diagnosis, and the decision-making function of the patient. The interest and, perhaps,
ambivalence of the clinical community to prenatal screening are understandable. Obstetricians
ordering prenatal screens are challenged by medical data associated with epidemiology,
pathology, and genetics, including: (1) prevalence of disease, (2) interpretive biochemical
reporting, and (3) the assessment and communication of patient-specific risks. Obstetricians
ordering screens will be called on to provide information generally used by other
specialists at other stages of care. What information, how it is biomedically determined,
its form for communication to patients, and pitfalls in the process are discussed.
Keywords
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References
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Article info
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© 1986 Published by Elsevier Inc.
