Raised levels of maternal serum secretory acetylcholinesterase may be indicative of fetal neural tube defects in early pregnancy.
BACKGROUND
To investigate the levels of maternal serum secretory acetylcholinesterase from a sample of pregnancies involving fetal neural tube defects and compare those results with alphafetoprotein levels.


METHODS
Secretory acetylcholinesterase levels were measured using a new Enzyme Capture Immunoassay, in a small blind prospective study. The study group comprised pregnancies covering a gestational age range of 13-24 weeks where 98 had normal fetuses, 21 suffered from neural tube defects, and 15 had other complications.


RESULTS
Maternal serum secretory acetylcholinesterase levels were found to be low and independent of gestational age between 14-20 weeks in a sample of normal pregnancies with normal alphafetoprotein levels. Raised levels of maternal serum secretory acetylcholinesterase were found in 100% of pregnancies involving spina bifida (17/17) and three of four anencephalics compared with raised alphafetoprotein levels found in 88% (15/17), and 100% (4/4) of the same samples. Only seven of 13 maternal serum samples from pregnancies with a normal outcome and none of the four twin pregnancies, all with raised alphafetoprotein levels, had raised secretory acetylcholinesterase levels.


CONCLUSIONS
Raised levels of maternal serum secretory acetylcholinesterase may provide a useful indicator of neural tube defects in early pregnancy.
Brennand
D M
DM
Department of Biochemistry, Avalon Biosciences Ltd, Bath University, Avon, UK.
Jehanli
A M
AM
Wood
P J
PJ
Smith
J L
JL
D000110:Acetylcholinesterase / Q000097:blood*; D000757:Anencephaly / Q000175:diagnosis; D004796:Clinical Enzyme Tests; D005260:Female; D005865:Gestational Age; D006801:Humans; D007124:Immunoenzyme Techniques; D009436:Neural Tube Defects / Q000175:diagnosis*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D016135:Spinal Dysraphism / Q000175:diagnosis; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D000110:Acetylcholinesterase