Amniotic fluid acetylcholinesterase: a retrospective and prospective study of the qualitative method

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Abstract
After retrospective evaluation with stored samples, the qualitative acetylcholinesterase (AChE) test was used prospectively in conjunction with .alpha.-fetoprotein (AFP) assay on 986 [human] amniotic fluid specimens. The main value of AChE is in classifying fluids in which the AFP level is near the threshold between normal and abnormal. Among abnormal pregnancies with raised AFP levels, neural tube defects can generally be distinguished from other abnormalities by careful appraisal of the AChE gel pattern, but confirmation of these other fetal abnormalities may require high resolution diagnostic ultrasonography and perhaps fetoscopy. Neural tube defects with false negative AFP levels can be detected by AChE, but AChE gives occasional false positives, it cannot be relied on in isolation for the diagnosis of neural tube defects.