Quantitative and qualitative assay of amniotic-fluid acetylcholinesterase in the prenatal diagnosis of neural tube defects.

In 110 amniotic fluids the specific acetylcholinesterase was determined quantitatively and qualitatively. In the quantitative assay there were a considerable number of false positives and false negatives, although the mean value of the normal controls differed significantly from that of neural tube defect pregnancies. By the electrophoretic separation of acetylcholinesterase, however, all fluid samples with borderline alpha-fetoprotein levels or fetal blood contamination could be correctly classified. With the exception of one skin-covered spina bifida all neural tube defects in the second trimester could be identified by this method. The second fast-moving band characteristic of the specific acetylcholinesterase was also present in abdominal wall defects and intrauterine death.