The molecular forms and membrane association of acetylcholinesterase (acetylcholine hydrolase, EC 3.1.1.7) and pseudocholinesterase (acylcholine acylhydrolase, EC 3.1.1.8) were determined in the presence of protease inhibitors in dissected regions of developing human fetal brain, as compared with parallel areas from mature brain. All areas contained substantial cholinesterase activities, of which acetylcholinesterase accounted for almost all the activity. Two major forms of acetylcholinesterase activity, sedimenting at 10-11S and 4-5S, respectively, were detected on sucrose gradients and possessed similar catalytic properties, as judged by their individual Km values toward [3H]acetylcholine (ca. 4 X 10(-4) M). The ratio between these forms varied by up to four- to fivefold, both between different areas and within particular areas at various developmental stages, but reached similar values (about 5:2) in all areas of mature brain. Acetylcholinesterase activity was ca. 35-50% low-salt-soluble and 45-65% detergent-soluble in various developmental stages and brain areas, with an increase during development of the detergent-soluble fraction of the light form. In contrast, pseudocholinesterase activity was mostly low-salt-soluble and sedimented as one component of 10-11S in all areas and developmental stages. Our findings suggest noncoordinate regulation of brain acetylcholinesterase and pseudocholinesterase, and indicate that the expression of acetylcholinesterase forms within embryonic brain areas depends both on cell type composition and on development.

The charts of all diabetic women and their infants delivered during the years 1983-1988 in our department were reviewed. The test group included consecutive gestational diabetic women class A1 (n = 65) and class A2 (n = 59), who delivered beyond 40 weeks of gestation. The mean gestational age at delivery was 40.90 weeks (range, 40.0 to 42.57) in class A1 and 40.49 weeks (range, 40.0 to 42.28) in class A2 patients. The first control group matched for age, parity, and presentation included 65 gestational diabetic patients class A1 and 59 A2 who delivered prior to 40 weeks' gestation. The second control group matched for age, parity, and presentation included 124 nondiabetic patients who delivered beyond 40 weeks of gestation (mean, 41.04 +/- 0.83 weeks). By allowing the pregnancies of gestational diabetic patients class A1 and class A2 to proceed beyond 40 weeks of gestation, we did not increase the incidence of perinatal mortality and morbidity rate. The cesarean section rate was low (10.76% in class A1 and 22.03% in class A2). We suggest that not only elective intervention prior to 40 weeks of gestation is to be avoided, but an attempt should be made to allow the gestational diabetics class A1 and class A2 to proceed to spontaneous labor.

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Influence of epidural anesthesia on the duration of labor was studied in 1,206 parturients having spontaneous singleton vaginal delivery. In primiparous women, the mean first stage was 3.52 hr in the epidural group, and 7.68 hr in the control group (p<0.001), the mean second stage was 25.78 min in the epidural group, and 43.58 min in the control group (p<0.001). In the multiparous women, the mean first stage was 2.06 hr in the epidural group, and 3.85 hr in the control group (p<0.001), the mean second stage was 17.06 min in the epidural group, and 25.42 min in the control group (p<0.0001). The conclusion is that epidural anesthesia shortens the duration of first and second stages of labor in singleton vaginal delivery.