Faint and positive amniotic fluid acetylcholinesterase with a normal sonogram.
OBJECTIVE
Both faint and positive amniotic fluid acetylcholinesterase determinations have been associated with fetal abnormalities. We evaluated the effect of a normal sonogram and positive or faint acetylcholinesterase level on the risk for anomalies.


METHODS
Between Jan. 1, 1989, and Feb. 1, 1995, 4859 amniocenteses were performed. Twenty-three cases of abnormal acetylcholinesterase determinations combined with normal sonograms were identified, and pregnancy outcomes were determined.


RESULTS
One abnormal karyotype was identified (45,X/47,XXX mosaic). No neural tube defects were seen in infants with an abnormal acetylcholinesterase determination and normal sonogram. One fetus of a twin pregnancy had a ventral wall defect that was not detected on ultrasonography. Seventy-three percent of infants were normal at birth, but 27% of the pregnancies had abnormal outcomes.


CONCLUSIONS
Advances in ultrasonography have led to improved detection of fetal abnormalities. With a normal karyotype, repeat invasive testing may not be necessary.
Brown
C L
CL
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201, USA.
Colden
K A
KA
Hume
R F
RF
Johnson
M P
MP
Treadwell
M C
MC
Drugan
A
A
Evans
M I
MI
D000110:Acetylcholinesterase / Q000378:metabolism*; D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000201:enzymology*; D000013:Congenital Abnormalities; D005260:Female; D006801:Humans; D007621:Karyotyping; D011247:Pregnancy; D011256:Pregnancy Outcome; D012016:Reference Values; D012307:Risk Factors; D016216:Ultrasonography, Prenatal
D000110:Acetylcholinesterase