The role of serum alpha-fetoprotein,free-β subunit-chorionic gonadotropin in the diagnosis of fetal open neural tube defects in the second trimester of pregnancy
Objective To investigate the role of serum alpha-fetoprotein(AFP)and free-β-human chorionic gonadotropin(free-β-HCG)in fetal open neural tube defects(ONTD).Methods A total of 150 pregnant women with suspected fetal ONTD admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine(Mudu People's Hospital)from July 2019 to July 2022 were selected.The results of serum AFP and free-β-HCG in pregnant women were analyzed using induced labor or delivery as the gold standard.Based on the gold standard,they were divided into the occurrence group(n=33)and the non-occurrence group(n=117).The diagnostic efficacy of serum AFP,free-β-HCG levels,and their combined detection for ONTD were analyzed.The diagnostic coincidence rates of serum AFP,free-β-HCG levels alone and their combined de-tection for different types of ONTD were also analyzed.Results The results of induced labor or delivery showed that there were 33 ONTD fetuses.A total of 26 ONTD fetuses were detected by serum AFP levels,while 27 were detected by serum free-β-HCG levels.In 32 cases of ONTD fetuses a combined detection of se-rum AFP and free-β-HCG levels were conducted.Compared to using serum AFP and free-β-HCG levels alone,the combined examination showed a higher sensitivity of 90.91%and accuracy of 96.67%,with a lower missed diagnosis rate of 9.10%.Additionally,the combined examination had a higher detection rate for spina bifida fe-tuses compared to using serum AFP and free-β-HCG levels alone,and this difference was statistically signifi-cant(P<0.05).Conclusion The combined detection of serum AFP and free-β-HCG levels in the second tri-mester can enhance the accuracy of ONTD diagnosis and offer a new and effective method for screening fetal ONTD in the second trimester.
Open neural tube defectAlpha fetoproteinFree β-human choionic gonadotophin
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NSTL
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