Prevention of neural tube defects in an urban health district.

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Abstract
An evaluation of voluntary prenatal screening for neural tube defects [NTD] with serum .alpha.-fetoprotein (s-AFP) is presented. During a 3 yr period, there were 52 fetuses with neural lesions. Of 46 mothers who bore a fetus with an open neural lesion, 25 were detected, of whom 23 agreed to the termination of their pregnancies. An unscreened group of 2331 mothers (17% of all deliveries) produced 14 fetuses with neural tube defects, an incidence of 6.0/1000, 1.8 times the incidence (3.3/1000) in the screened group. Pitfalls occurring in the assessment of hyper-.alpha.-fetoproteinemia included inaccurate gestational dating and allowance for excessive body weight. The results of a robost AFP-NTD screening program supported in selected cases by ultrasonar visualization of the spine argue for its continuance in this district.