Fetal hepatic haemangioendothelioma: a new association with elevated maternal serum alpha-fetoprotein

✍ Scribed by Aizeddin A. Mhanni; Bernard N. Chodirker; Jane A. Evans; Savas Menticouglou; Nathan Wiseman; Nigel MacDonald; Albert E. Chudley

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 55 KB
• Volume: 20
• Category: Article
• ISSN: 0197-3851
• DOI: 10.1002/(sici)1097-0223(200005)20:5<432::aid-pd821>3.0.co;2-z

✦ Synopsis

may be presented to patients by programs using different birth prevalence curves is minimized. From a clinical standpoint, consistency in the ®rst and second trimester maternal-age speci®c risks quoted to patients by different counsellors is clearly preferable.

Estimates for survival based on the follow-up of known affected pregnancies (`direct analyses') generally show even greater variability (e.g. from amniocentesis 50±76%) (Hook et al., 1989(Hook et al., , 1995;;Morris et al., 1999). There are concerns about counting losses prior to a decision to terminate (Morris et al., 1999), possible differences in loss rates depending on the reason for referral (Cuckle, 1999) and imprecision due to the small numbers of cases in some of the studies (Hook et al., 1989). Use of carefully selected data in actuarial analysis can potentially address these issues but there will still be some additional problems in interpreting the results. Decisions to terminate may sometimes be in¯uenced by post-diagnosis ultrasound detection of signi®cant physical anomalies. Even in the absence of any additional ultrasound information, it is likely that management of known Down syndrome affected pregnancies will sometimes differ from usual practice. The results of the studies that evaluate pregnancy outcomes are therefore extremely useful in providing information for women with a known affected pregnancy, but these studies may not be readily applicable to the generation of in utero maternal-age speci®c risks.