Low level of maternal serum alpha-fetoprotein: its associated anxiety and the effects of genetic counseling

Article Abstract:

To evaluate the anxiety experienced by pregnant women younger than 35 years who have received a report of low maternal serum alpha-fetoprotein level (associated, but not exclusively, with a Down syndrome pregnancy), 52 women and their partners were evaluated according to the State Trait Anxiety Inventory. The Inventory was administered before and after a 45-minute counseling session with a genetic counselor who explained the significance of the alpha-fetoprotein test: that it can indicate the age-related risk of Down syndrome. A group of 25 women of similar demographic characteristics but with normal maternal serum alpha-fetoprotein levels functioned as controls. Results showed that the average anxiety score when patients first visited the counselor was 52 (for comparison, average anxiety in an acute anxiety reaction is 48); after counseling, the score fell to 47. The score for males was initially 44.5, and it fell by only 1.5 points after counseling. Controls' average anxiety level was 36. An evaluation is presented of the maternal serum alpha-fetoprotein test; it has low sensitivity (true positives) and specificity (true negatives), and a low alpha-fetoprotein level can result from a variety of factors other than chromosomal abnormalities. Counseling appeared to reduce these patients' anxiety, but other studies have not found this to be the case. Better tests should be developed that carry lower false-positive rates than the maternal serum alpha-fetoprotein assay. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Anxiety, Genetic counseling, Prenatal diagnosis, Alpha fetoproteins

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The effect of fetal movement counting on maternal attachment to fetus

Article Abstract:

Maternal attachment to the fetus (the mother's affiliation and interaction with the fetus) develops as a result of several factors, one of which is the onset of fetal movement. It is possible that if mothers are encouraged to be more aware of fetal movement, their attachment may be deepened. This was tested by randomly assigning 213 women whose pregnancies were between 28 and 32 weeks gestation to a group that was taught to count fetal movements using the Sadovsky (63 women) or Cardiff (63 women) charts; the remaining 88 women did not count fetal movements. These two methods are the most commonly used ways of counting fetal movements: in the Sadovsky method, movements are counted three times daily after meals, while in the Cardiff method, the first 10 movements each morning are counted. The subjects' degree of fetal attachment was tested using the Cranley scale after one month of counting. Results showed that the maternal-fetal attachment scores increased among the women who counted the fetal movements. This was true for both the total scores and for each of the five subscale scores of the Cranley scale. No differences were seen between the Sadovsky and Cardiff groups. These findings indicate that the maternal-fetal attachment process can be aided, an improvement that may encourage mothers' compliance with prenatal health care. (Consumer Summary produced by Reliance Medical Information, Inc.)

Maternal and infant welfare, Infant welfare, Maternal welfare, Fetal movement, Fetal movements

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Maternal serum analyte levels after first-trimester multifetal pregnancy reduction

Article Abstract:

Second trimester levels of two hormones that may be markers of Down syndrome may not be affected by first trimester reductions of pregnancies with multiple fetuses. Researchers obtained second trimester blood samples from 10 women with multifetal pregnancies who had undergone abortions in the first trimester of at least one fetus. Alpha-fetoprotein (AFP) levels were high after pregnancy reduction and remained high into the second trimester. Blood levels of hCG and unconjugated estriol were high, as is consistent with unreduced multifetal pregnancies. Blood levels of hCG and unconjugated estriol taken from women with multifetal pregnancies may be used in the future to diagnose fetuses with abnormal chromosomes. AFP may not be a reliable marker in these pregnancies.

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