{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:28:13Z","timestamp":1777483693048,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2005,11,21]],"date-time":"2005-11-21T00:00:00Z","timestamp":1132531200000},"content-version":"vor","delay-in-days":5834,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[1989,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Seventeen centres from Australia, Britain, France, and the United States collaborated in a study to compare amniotic fluid acetylcholinesterase (AChE) determination by gel electrophoresis and amniotic fluid alpha\u2010fetoprotein (AFP) measurement as diagnostic tests for open neural tube defects. The study was based on 32 642 women with singleton pregnancies (including 428 with open spina bifida and 238 with anencephaly) who had an amniocentesis at 13\u201324 weeks' gestation. The AChE test yielded a detection rate for open spina bifida of 99 per cent (95 per cent confidence interval 98\u2013100 per cent), 98 per cent for anencephaly (95 per cent confidence interval 96\u2013100 per cent), and a false\u2010positive rate of 0.34 per cent (95 per cent confidence interval 0.28\u20130.40 per cent) excluding miscarriages, intrauterine death, and serious fetal abnormalities. The false\u2010positive rate was 0.30 per cent among the 13 centres that used a specific AChE inhibitor in the test. Comparable rates for the AFP test were less favourable. (For example, the open spina bifida detection rate was 90 per cent and the false\u2010positive rate was 0.46 per cent using the cut\u2010off levels specified in the U.K. Collaborative AFP Study.) The AChE false\u2010positive rate was lower in samples that were not bloodstained (0.16 per cent) than in those that were (2.4 per cent). It was higher in women who had an amniocentesis on account of a raised maternal serum AFP level (0.56 per cent) than in those who had one for other reasons (0.29 per cent). The best results were obtained by a combination of the two tests, an effective and economical policy being to perform the AFP measurement on all amniotic fluid samples and an AChE test on samples with AFP levels greater than or equal to 2.0 multiples of the normal median (about 5 per cent of all samples). Using this policy, the open spina bifida detection rate was 96 per cent and the false\u2010positive rate was 0.14 per cent (0.06 per cent for samples that were not bloodstained and 1.2 per cent for those that were; 0.40 per cent for women with raised serum AFP levels and 0.09 per cent for other women). This policy offers a useful improvement to the prenatal diagnosis of open spina bifida.<\/jats:p>","DOI":"10.1002\/pd.1970091202","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T22:10:10Z","timestamp":1172959810000},"page":"813-829","source":"Crossref","is-referenced-by-count":49,"title":["Amniotic fluid acetylcholinesterase measurement in the prenatal diagnosis of open neural tube defects. Second report of the collaborative acetylcholinesterase study"],"prefix":"10.1002","volume":"9","author":[{"given":"Nicholas","family":"Wald","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Cuckle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran","family":"Nanchahal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,11,21]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1970040503"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1982.tb05033.x"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1984.tb03675.x"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.25.9.606"},{"key":"e_1_2_1_6_1","first-page":"10","article-title":"Fetal calf serum as cause of false\u2010positive amniotic fluid acetylcholinesterase gel tests","volume":"2","author":"Brock D. 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Collaborative Study on Alpha\u2010fetoprotein in Relation to Neural\u2010Tube Defects","year":"1977","journal-title":"Lancet"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)91144-9"},{"key":"e_1_2_1_19_1","first-page":"651","article-title":"Amniotic\u2010fluid alpha\u2010fetoprotein measurement in antenatal diagnosis of anencephaly and open spina bifida in early pregnancy","author":"U. K. Collaborative Study on Alpha\u2010fetoprotein in Relation to Neural Tube Defects. Second Report","year":"1979","journal-title":"Lancet"},{"key":"e_1_2_1_20_1","volume-title":"Textbook of Ultrasound in Obstetrics and Gynecology","author":"Wald N. 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