Prenatal Prediction of Risk of the Fetal Hydantoin Syndrome

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Abstract
After the publication of our paper “Prenatal Prediction of Risk of the Fetal Hydantoin Syndrome” (May 31, 1990, issue),1 our laboratory received many requests to assay epoxide hydrolase activity in samples of chorionic villi. Our prior work had established standards for measuring this enzyme in amniocytes and skin fibroblasts and used those standards to assist in predicting the risk of the fetal hydantoin syndrome. In an effort to determine whether measurement of epoxide activity in chorionic-villus samples could be used in a similar manner, we cultured 50 samples randomly obtained from pregnant women who were requesting fetal karyotyping because of their advanced age (none were taking phenytoin [Dilantin] or any other anticonvulsant). The samples were analyzed according to the technique described in our paper1 and were compared with amniocyte controls from the previous study that were considered to have activity of 100 percent. In each experiment, controls were run simultaneously, and enzyme activity in the chorionic-villus samples was expressed as a percentage of control levels. The mean level of activity in the 50 samples was 36.7 percent (95 percent confidence interval, 32.7 to 40.6). The standard deviation was 13.9 percent, whereas sample variation was 2 percent on separate analyses of the same cells. The previously determined mean level of activity in 100 amniocyte samples was 51.7 ±2.5 percent of control. To determine whether direct rather than cultured preparations of chorionic villi would be more comparable, we tested four direct preparations and found enzyme levels lower than those in cultured samples.

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