The psychological effects of false-positive results in prenatal screening for fetal abnormality: A prospective study

The purpose of the study was to describe the impact of false-positive results from initial maternal serum alpha-fetoprotein (MS-AFP) screening. The analyses compared two groups of women, those receiving a negative result (n = 346) and those receiving an initial positive result (n = 26), over four time points—prior to testing, immediately after testing, later in pregnancy, and in the post-partum period. Receiving an abnormal result was associated with high levels of anxiety which were reflected in increased worry about the baby's health and a more negative attitude towards the pregnancy and the baby. Women who had an initial abnormal result were offered a variety of further tests. Those women who went on to have amniocentesis were less worried about their baby's health in the third trimester and also less anxious post-partum than those who did not have amniocentesis. In view of the increasing number of screening tests available, it is necessary to establish whether and how these levels of distress can best be reduced.     

Genetic amniocentesis in multiple gestations

Thirty-one genetic amniocenteses involving multiple gestations were performed in the genetics unit between 1976 and 1982. Three sets of triplets were included. Precise locations of the sacs were determined using real-time ultrasonography and successful sampling of all sacs was accomplished. Spontaneous abortions occurred in two normal twins and one normal triplet gestation. Two therapeutic abortions were performed for fetal abnormalities. Two cases of discordance for trisomy 21 (one twin and one triplet) were allowed to continue; the twin case terminated at 25 weeks' gestation with neonatal deaths and the triplets are alive and well.     

Maternal serum human chorionic gonadotropin levels in twin pregnancies

Introduction of combined screening with maternal serum alpha-fetoprotein and human chorionic gonadotropin (MShCG) assays for fetal chromosome defects requires establishment of the normal range for twins. This report documents that the normal range for MShCG between 15 and 19 weeks in twin gestations was 1.84–2.41 multiples of the singleton median. Of the 192 twin pregnancies studied, 31.7 and 47.9 per cent had MShCG values ≥2.5 and ≥ 2.0 multiples of the singleton median, respectively.     

First-trimester maternal serum alpha-fetoprotein and human chorionic gonadotropin screening for chromosome defects

The aim of this study was to determine the efficacy of combined maternal serum alpha-fetoprotein (MSAFP) and maternal serum human chorionic gonadotropin (MShCG) screening in detecting chromosome defects in the first trimester of pregnancy. Sera of 492 women (previously assayed for MSAFP) were analysed for MShCG under code without knowledge of cytogenetic results. Overall, 48 of 492 patients (9·8 per cent) had either an MSAFP multiple of the median ⩽0·5 or an MShCG β/a z ratio multiple of the median ⩽ 0·25, eight of whom had a fetus with a serious chromosome defect. A third of fetuses with Down' s syndrome and 83 per cent with trisomy 18 were detected at a potential‘cost’ of providing chorionic villus sampling or amniocentesis in 8·6 percent of women screened.     

The Lower Susquehanna River Gorge and Floodplain (U.S.A.) as a Riparian Refugium for Vernal, Forest-Floor Herbs

A survey of vernal, forest-understory herbs was conducted on 52 routes, 10 sample sites each, along the Susquehanna River and its major and minor tributaries in southeastern Pennsylvania and northeastern Maryland. Mature forest stands, as compared to younger successional stands, had a greater diversity and cover of native understory herbs and greater frequencies of K -selected species such as Trillium flexipes and Dicentra canadensis . Vernal herbs with a high fidelity to the river corridor were likely to be more mesic in habitat preference, to occupy a more limited range of habitats, and to be less tolerant to disturbance than species that are also common in adjacent upland areas. The best vernal wildflower sites, which are usually in mesic or floodplain forest, may also be the most vulnerable to species loss if the canopy is removed or the forest is otherwise disturbed. Disturbance-sensitive herbs have been nearly extirpated from the Susquehanna tributaries by very intensive human development. Preservation of an appropriate matrix of microhabitats, particularly along the main river and at the mouths of the creeks, is critical to protecting the vernal flora of the region.     

Population Viability Analysis of Spring Chinook Salmon in the South Umpqua River, Oregon

Run sizes of spring chinook salmon in the South Umpqua River in Oregon have declined dramatically since the early part of this century. Habitat degradation is thought to be an important factor contributing to the decline of this stock, and qualitative assessment suggests the stock is at moderate risk of extinction. We use data from this and similar stocks to develop an age-structured, density-dependent model of the population dynamics that incorporates both demographic and environmental stochasticity. Under the assumption of no further habitat destruction, the population is predicted to have a greater than 95% probability of persistence for 200 years. However, sensitivity analysis for the density-dependence estimated from historical run-return data shows that substantially lower predicted viabilities are also statistically consistent with the data. A model that simulates continued habitat degradation results in almost certain extinction within 100 years.