title: Faint and positive amniotic fluid acetylcholinesterase with a normal sonogram.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Brown
authors.forename: K A
authors.initials: KA
authors.lastname: Colden
authors.forename: R F
authors.initials: RF
authors.lastname: Hume
authors.forename: M P
authors.initials: MP
authors.lastname: Johnson
authors.forename: M C
authors.initials: MC
authors.lastname: Treadwell
authors.forename: A
authors.initials: A
authors.lastname: Drugan
authors.forename: M I
authors.initials: MI
authors.lastname: Evans
mesh_terms: 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
chemical_list: D000110:Acetylcholinesterase