Analysis of normal and abnormal amniotic fluid cells in vitro by cinemicrography

Time-lapse cinemicrography has been used to study cell behaviour and movement in long- and short-term amniotic fluid cultures from various types of fetus. These included several with a neural tube defect (9 anencephalics, 5 spina bifidas, 2 encephaloceles), 1 with an abdominal wall lesion (omphalocele) and 9 controls with no open lesion. In short-term (less than 3 days) amniotic fluid cultures from normal fetuses, non-adherent squamous cells dominate, but there is a small population of cells which, in the longer term (approximately 4 weeks), will form colonies of epithelioid and fibroblastic cells. In addition, there is a further group, called 'AF' by Hoehn et al. (1974), which have the ability to form syncitial strands and are often multinucleated; these cells seem to be trophoblastic in origin. In contrast to the controls, short-term anencephalic cultures contained many adherent cells; these were mainly latex-particle-phagocytosing macrophages and neural cells. In long-term cultures, the neural cells dominate and differentiate into a range of recognizable forms whose type and behaviour seem to depend on cell density, time in culture and extent of cell-cell contacts. In the spina bifida and encephalocele cultures, there were initially far fewer adherent cells than in the anencephalic ones, but, after approximately 2 weeks in vitro, a range of neural cell types could be recognized in addition to those seen in the controls. In the context of prenatal diagnosis, the presence of neural cells certainly indicates that the fetus has a NTD, but the difficulty of standardizing culture conditions implies that any differential diagnosis on the basis or morphology and movement will be difficult. If, as seems likely, the AF cells of Hoehn et al. (1974) are indeed trophoblastic, amniotic fluids from the second trimester may provide a useful source of these cells.