Sensitivity of Ultrasound in Detecting Spina Bifida

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Abstract
We believe that Nadel and his colleagues (Aug. 30 issue)1 are incorrect in suggesting that there is no need for amniocentesis in patients with elevated maternal serum alpha-fetoprotein levels and a normal ultrasonographic examination. Their conclusion rests on the belief that ultrasonography will virtually never miss a case of open spina bifida (detection rate virtually 100 percent) in the fetuses of women with raised maternal serum alpha-fetoprotein levels and on the assumption that there will be no false positive results.