An acceleration is an abrupt increase in the fetal heart rate above baseline with onset to peak of the acceleration less than 30 seconds and less than 2 minutes in duration.

Adequate accelerations are defined as:

Shortening of the hands or feet

A birth defect in which there is partial or complete absence of the corpus callosum (the bundle of nerve fibers that connects the two hemispheres of the brain). 

ACC may occur as an isolated defect, but it is frequently associated with other malformations, chromosomal abnormalities (trisomy 18 an trisomy 8), and genetic syndromes. The outcome of the abnormality depends on the underlying cause and the presence of other structural defects. Isolated ACC (in particular partial ACC) is associated with no or mild neurologic impairment in a large proportion of cases. ACC occurring as part of a syndrome may be associated with severe mental retardation and seizures. ACC does not cause death in the majority of children.

Ultrasound findings include absence of the corpus callosum and cavum septum pellucidum, 'teardrop' configuration of the lateral ventricles, dilatation and upward  displacement of the third ventricle (interhemispheric "cyst") , and abnormal branching of the anterior cerebral artery. Magnetic resonance imaging is sometimes useful in confirming the diagnosis. 

Additional abnormalities commonly found in association with ACC include include Chiari malformations, schizencephaly, encephaloceles, Dandy-Walker malformations, holoprosencephaly, heart defects, and GI or genitourinary malformations.

The risk of recurrence is ~ 1% for sporadic cases, 25% if ACC is associated with an  autosomal recessive cause, and 50% of males will be affected if inherited as an  X-linked recessive disorder.

A protein produced by the fetal liver and yolk sac that can be detected in the mother's blood. Alpha-fetoprotein levels rise gradually throughout most of pregnancy and level off near term. High levels of alpha-fetoprotein are associated with a more advanced pregnancy than expected, multiple pregnancy, fetal death (including a vanished twin), an opening in the spine (spina bifida), an opening in the head (anencephaly), or an opening in the abdominal wall (gastroschisis).  Low levels may be associated with Down syndrome, trisomy 18, and some cases of Turner syndrome.

Amniocentesis

A procedure in which a needle is inserted into the uterus and a sample of the fluid surrounding the fetus is drawn out. The procedure may be done to evaluate the fetal chromosomes, to determine fetal lung maturity, or to obtain fluid to culture for possible infections. The procedure may also be performed to remove an excessive amount of amniotic fluid.

Amniotic fluid

The liquid that surrounds the fetus. Amniotic fluid is nearly all fetal urine with a small amount of fluid contributed by the lungs.

Amniotic Fluid Index (AFI)

An ultrasound procedure used to asses the amount of amniotic fluid. The amniotic fluid index is measured by dividing the uterus into four imaginary quadrants. The deepest, unobstructed, vertical pocket of fluid is measured in each quadrant. The four pocket measurements are then added to calculate the AFI. A normal AFI is between 5 and 25 cm.

Amniotic sac

The membrane (amnion) that surrounds the fetus and the amniotic fluid.

Anencephaly

A birth defect resulting in the absence of a major portion of the skull and brain. Anencephaly results when the upper portion of the neural tube fails to close. The condition is not compatible with life, and infants usually die within a few days after delivery. See picture

Angelman syndrome ("Happy Puppet Syndrome")

A disorder characterized by a large jaw and open-mouthed expression revealing the tongue, severe speech impairment, motor and intellectual retardation, ataxia, poor muscle tone, seizures, frequent laughing, smiling, and excitability. The disorder is usually caused by abnormalities of chromosome 15. 

A deletion of chromosome in the 15q11-q13 region accounts for up to 75% of cases and has a less than 1% recurrence risk. Mutations in the UBE3A gene on chromosome 15 accounts for 6 to 20% of cases and has a recurrence risk of less than 1% unless the patient's mother carries the UBE3A mutation on her own paternally inherited chromosome 15. In the latter case there is a 50% recurrence risk. Angelman syndrome is less commonly caused by inheritance of two copies of chromosome 15 from the father and no maternal copy of chromosome 15 (uniparental disomy) , or mutations in the imprinting center of the UBE3A gene.

Aniridia

Absent or partially absent iris accompanied by macular and optic nerve hypoplasia. Symptoms include poor vision  sensitivity to light (photophobia), and nystagmus. Frequently associated  abnormalities  include glaucoma and cataracts.  Mutation of the PAX 6 gene or deletion of a regulatory region controlling its expression, appears to be responsible for aniridia occurring  as an isolated ocular defect . The condition is autosomal dominant.

Aniridia may also occur as part of the Wilms tumor-aniridia-genital anomalies-retardation (WAGR) syndrome, with a deletion of 11p13 involving the PAX6 (aniridia) locus and the adjacent WT1 (Wilms tumor) locus.

Antenatal steroids

Steroids (either betamethasone or dexamethasone) given to help the fetal lungs and other organs mature more rapidly. Antenatal steroids are given when preterm delivery is anticipated between 24 and 34 weeks' gestation with intact membranes, and at 24 to 32 weeks' with ruptured membranes.