TY - JOUR
T1 - Amniotic fluid acetylcholinesterase
T2 - Implications of an inconclusive result
AU - Drugan, Arie
AU - Syner, Frank N.
AU - Belsky, Robin
AU - Koppitch, Frederick C.
AU - Evans, Mark I.
PY - 1988
Y1 - 1988
N2 - The implications of an “inconclusive” acetylcholinesterase test (a faint but true band) in amniotic fluid were studied over a 2 1/2-year period in our laboratory. One thousand one hundred fifty-four amniotic fluid samples were tested for acetylcholinesterase and α-fetoprotein; the rate of an inconclusive acetylcholinesterase result was 3.3% (38 of 1154). Fourteen such results were found in patients with a high amniotic fluid α-fetoprotein level (23.3%), and 24 results were associated with normal amniotic fluid αB-fetoprotein levels (2.19%). The rates of congenital fetal malformation associated with an inconclusive acetylcholinesterase result in the two groups were 57.14% and 37.5%, respectively. In amniotic fluid samples obtained before 15 weeks' gestation, there was a higher rate of inconclusive acetylcholinesterase tests (9.29%), but a lower percentage of malformed fetuses were found compared with later in pregnancy (2.46% and 56%, respectively). Thus we suggest the terminology “equivocal” for early specimens and “suspicious” for later specimens. If obtained in early second trimester and the ultrasound scan is normal, such findings implicate the need for a careful search for fetal malformations. A positive pregnancy outcome may be expected in most cases.
AB - The implications of an “inconclusive” acetylcholinesterase test (a faint but true band) in amniotic fluid were studied over a 2 1/2-year period in our laboratory. One thousand one hundred fifty-four amniotic fluid samples were tested for acetylcholinesterase and α-fetoprotein; the rate of an inconclusive acetylcholinesterase result was 3.3% (38 of 1154). Fourteen such results were found in patients with a high amniotic fluid α-fetoprotein level (23.3%), and 24 results were associated with normal amniotic fluid αB-fetoprotein levels (2.19%). The rates of congenital fetal malformation associated with an inconclusive acetylcholinesterase result in the two groups were 57.14% and 37.5%, respectively. In amniotic fluid samples obtained before 15 weeks' gestation, there was a higher rate of inconclusive acetylcholinesterase tests (9.29%), but a lower percentage of malformed fetuses were found compared with later in pregnancy (2.46% and 56%, respectively). Thus we suggest the terminology “equivocal” for early specimens and “suspicious” for later specimens. If obtained in early second trimester and the ultrasound scan is normal, such findings implicate the need for a careful search for fetal malformations. A positive pregnancy outcome may be expected in most cases.
KW - Acetylcholinesterase
KW - neural tube defects
KW - prenatal diagnosis
KW - α-fetoprotein
UR - http://www.scopus.com/inward/record.url?scp=0023688149&partnerID=8YFLogxK
U2 - 10.1016/S0002-9378(88)80111-X
DO - 10.1016/S0002-9378(88)80111-X
M3 - Article
C2 - 2457320
AN - SCOPUS:0023688149
SN - 0002-9378
VL - 159
SP - 469
EP - 474
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 2
ER -