HDlive can provide clearer facial images than conventional 3D ultrasound. In particular, HDlive is superior to conventional 3D ultrasound for the depiction of eye fissures because of its shadowing effect. HDlive may be a useful diagnostic modality for the antenatal evaluation of subtle fetal facial dysmorphism.

Our results suggest that ethnicity should be considered when evaluating fetal behavior, especially during assessment of fetal facial expressions. Although there was a difference in the total KANET score between Japanese and Croatian populations, all the scores in both groups were within normal range. Our results indicate that ethnical differences in fetal behaviour do not affect the total KANET score, but close follow-up should be continued in some borderline cases.

Our results show that there is no difference in fetal behavior between male and female fetuses in the third trimester of pregnancy. These results suggest that 4D ultrasound study examining fetal behavior does not need to consider the factor of fetal sex.

We present the latest HDlive studies of fetal development and behavior during pregnancy. Marked changes of embryonic and fetal development and movement with advancing gestation were noted in the first trimester of pregnancy. Various realistic facial expressions (or facial movements) were recognized in the second and third trimesters. In particular, blinking, mouthing, swallowing, yawning, tongue expulsion, and sucking were clearly depicted. Moreover, various extraordinarily realistic features of fetal emotion-like behavior were identified. HDlive observation of fetal behavior and facial expressions may reflect the normal and abnormal neurological development of the fetus. HDlive may become an important modality in future research on fetal neurobehavioral development and assist in evaluation of the fetal brain function.

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