ABSTRACT
Neural tube defects, resulting from failure of the neural tube to close during the fourth week of embryogenesis, are the most common severely disabling birth defects in most populations. We assayed alpha fetoprotein [AFP] in serum samples of pregnant women during 15 to 20 weeks of gestation using immuno-enzymatic method [Eliza] in east Azerbaijan/Iran. The results obtained from the first 100 samples were used to calculate the median levels of maternal serum AFP in our ethnic population and the resulted Multiple of Median [MOM] were employed in Prisca software to obtain the likelihood ratio for each pregnancy. Among the 300 pregnancies which were screened for Neural Tube Defects [NTDs], 9 were detected as screen positives. The following targeted ultrasonography revealed fetuses affected by open neural defects in two pregnancies, polyhydraminous with no NTDs in two others and bilateral cleft lip in the one. The screening results were confirmed by clinical examination of the aborted fetuses or newborns. The outcome of the last pregnancy showed bilateral cleft lip + cleft palate and congenital pyloric stenosis at birth. The newborns resulted from two other screen positive pregnancies were normal. No information was obtained from the two remaining pregnancies after the ultra-sound scanning. The median weight of pregnant mothers in sample population was 63.34 +/- 10/66, in screen positive patients 61/11 +/- 11.92 and in screen negative patients 63.30 +/- 10.63. The results obtained from antenatal maternal serum screening in the present study compares favorably with the results from reference centers using similar screening strategies. The method employed in this research is reliable and can be readily applied for screening of a large population of pregnant women for open NTDs