== Clinical Summary ==

This 44-year-old woman was 12 weeks pregnant with her third child when routine blood work showed a maternal serum alpha-fetoprotein level that was lower than expected for her stage of pregnancy. At 15-weeks of gestation she underwent ultrasound-guided amniocentesis and samples of the fluid containing cells were smeared onto glass slides for fluorescent in situ hybridization (FISH). The remainder of the sample was spun down and the fluid was sent for analysis and the cells were cultured for karyotyping.

== Images ==