Antenatal diagnosis of fetal seizure activity with use of real-time ultrasound

Conover, Wayne B.; Yarwood, Robert L.; Peacock, Mark D.; Thomas, Barbara A.

doi:10.1016/s0002-9378(86)80036-9

Cited by 16 publications

(19 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the literature search beginning in 1970, 48 articles were found, examining 104 fetuses. In 60 cases (36 articles13–48) the motor activity was categorized as hypokinetic and in 44 (15 articles17, 42, 44, 49–60) it was hyperkinetic; three articles reported fetuses with both hypokinetic and hyperkinetic movements17, 42, 44. The 5‐yearly distribution of the articles has been stable since 1980.…”

Section: Resultsmentioning

confidence: 99%

“…In those with anencephaly six showed increased, four showed normal and four showed reduced movements. Increased and reduced movements were described in trisomy 18, hydranencephaly and Apert's syndrome42, 51, 53, 56. Burst–pause patterns were described in seven fetuses of which five were anencephalic, one had Fanconi anemia and one had myoclonic encephalopathy.…”

Section: Resultsmentioning

confidence: 99%

“…Qualitatively, all 37 examined were found to be abnormal. Four fetuses had seizure‐like activity: myoclonic encephalopathy55, olivopontocerebellar hypoplasia58, hydranencephaly53, and microcephaly57. It is noteworthy that, with respect to those with chromosomal anomalies, six of 11 cases of trisomy 21 exhibited an abnormal quality of NSMP (at 17 and 20 weeks)51.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Changes in fetal motility as a result of congenital disorders: an overview

Vries

Fong

2007

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Changes in fetal motility as a result of congenital disorders: an overview

Vries

Fong

2007

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“…A FHR tracing was available in ten of the 13 cases, including ours; it was normal in three 2-4 , had low variability in two 7,8 and showed low variability and repetitive deceleration in three 2,5,8 . In one additional case, FHR variability was increased during the jerking movements, and was followed by reduced variability with frequent and prolonged decelerations 30 min later 9 .…”

Section: Discussionmentioning

confidence: 80%

“…To date, only 13 cases, including ours, have been reported in the literature; these had a median gestational age of 35.5 weeks (range 20-42) ( Table 1) [1][2][3][4][5][6][7][8][9] . In 11 cases fetal seizures were visualized by ultrasonography as repetitive and synchronous jerky movements of the limbs, but no specific criteria were reported to assist in the prenatal diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Fetal seizures: case report and literature review

Patanè

Ghidini

2001

J Matern Fetal Neonatal Med

View full text Add to dashboard Cite

We report a case of fetal seizures secondary to lissencephaly. Among the 13 published cases of fetal seizures, including ours, diagnosed at a mean gestational age of 35.5 weeks (range 20-42), a fetal heart rate tracing was available in ten and showed a normal pattern in three, low variability in two and repetitive decelerations or bradycardia in five. The most common cause of fetal seizures was congenital anomalies (seven of 13), mainly of the central nervous system (six of seven). Outcome among the 11 liveborn neonates included death by 6 months of age in eight cases, and mental or motor delay in three.Key words: fetal seizure; congenital anomalies; fetal heart rate INT ROD U C TIONFetal seizures are a rare antepartum complication. Previous cases have been diagnosed by ultrasonographic demonstration of repetitive and synchronous jerky movements usually associated with a poor fetal and neonatal outcome. We report a case of fetal seizures diagnosed at delivery, and review the literature on the subject. C ASE RE PO RTThe patient was a 31-year-old woman, G2 P1001, admitted at 42.0 weeks' gestation in spontaneous labor. The prenatal course was uneventful with the exception of two episodes of sudden and unusually strong fits of fetal movements during the month preceding delivery. The woman denied intake of medications or illicit drug use during pregnancy.The maternal serum triple screen results were normal. Two ultrasonographic examinations during pregnancy documented normal fetal anatomy and appropriate growth. The fetal heart rate (FHR) was reported as normal during routine office visits. The obstetric history was remarkable for a Cesarean delivery at term for failed induction. The amniotic fluid volume was adequate at a limited ultrasound examination on admission. On admission, FHR monitoring was reassuring, with a baseline of 140 beats/min. Four hours later, the cervix progressed to 3 cm of dilatation, with the vertex at the 0 station. Mild variable decelerations in FHR were noted, followed by bradycardia to 100 beats/min lasting 5 min. There was no evidence of uterine hypertonus, vaginal bleeding, or loss of station of the vertex. The FHR slowly recovered to the baseline over 8 min with oxygen administration and left lateral decubitus and intravenous hydration. Preparation was made for a repeat Cesarean section. At laparotomy there was no sign of uterine rupture. A male infant weighing 3640 g was delivered with some difficulty, owing to the presence of a tonic seizure. Apgar scores were 6, 7 and 9 at 1, 5 and 10 min, respectively; umbilical artery pH was 7.37, base deficit 1. The neonate was apneic, depressed and hypertonic at all extremities and neck. He was intubated and resuscitated, and admitted to the neonatal intensive care unit. At 20 min of life the first generalized tonic-clonic seizure was observed. The infant continued alternating tonic with tonic-clonic seizures for the following 3 days, despite therapy with different and multiple intravenous antiseizure treatments, including lorazepam 0.1 mg/kg, diaz...

show abstract

Fetal grasping of the umbilical cord causing variable fetal heart rate decelerations

Petrikovsky¹,

Kaplan

1993

J of Clinical Ultrasound

View full text Add to dashboard Cite

Recent advances in ultrasound technology have resulted in improved imaging of subtleties of fetal structure and fetal behavior. Rare and irregular events in fetal life, such as fetal seizure activity in neurologically compromised fetuses, have been described.'" We report a case in which persistent variable fetal heart rate (FHR) decelerations were associated with an unusual pattern of fetal behavior-periodic compression of the umbilical cord by a grasping fetal hand. CASE REPORTA 35-year-old healthy woman, gravida 1, para 0, was referred for the assessment of amniotic fluid volume after persistent mild-to-moderate variable decelerations were noticed on the FHR strip. The nonstress test (NST) was otherwise reactive.An ultrasound examination revealed a single fetus in a vertex presentation, with an anterior placenta and normal amniotic fluid volume. Fetal biometric parameters were consistent with a fetal age of 36 weeks, menstrual age (MA). A fetal anatomic survey was normal. There was no nuchal cord detected. A fetal hand was visualized, and it was compressing the umbilical cord periodically by grasping it (Figure 1). These compressions altered the blood flow in the umbilical cord as evidenced by the simultaneous appearance of variable FHR decelerations. Fetal heart rate decelerations as great as 15 beats to 20 beats per minute lasting 15 seconds to 20 seconds with abrupt return to baseline were recorded.All attempts to change maternal position or manually displace the fetus t o terminate the 642 variable decelerations were unsuccessful. Finally, fetal vibratory acoustic stimulation was performed using an artificial larynx (Western Electric, New York, NY) with the maximum vibratory force of 45 db at 100 Hz. A "startle reflex" was observed and the fetus released its grasp of the umbilical cord. Repeat NSTs were reactive, and the variable decelerations disappeared. Nonstress tests repeated weekly after this episode were reactive with no periodic changes.The patient had a normal spontaneous vaginal delivery at term; she delivered a 3600-g baby boy. Apgar scores were 8 at 5 minutes and 9 at 10 minutes. No umbilical cord abnormalities were seen at the time of delivery. DISCUSSIONUltrasonography has provided evidence of fetal hands clasping each other, exploring other parts of the body, and grasping the umbilical cord as early as 18 weeks to 19 weeks, MA. Sherer et al.3 observed continuous fetal sucking of the umbilical cord over a period of 10 minutes in two fetuses at 30 weeks to 32 weeks, MA. Intermittent grasping of the umbilical cord for a period of several minutes in a fetus at 26 weeks, MA, has also been r e p~r t e d .~ None of these cases was associated with FHR changes, though the possibility of such a consequence was entertained.As the fetal grasp reflex develops, the possibility arises that the fetus will grasp the umbilical cord with enough force to actually cause transient hypoperfusion, noted clinically as a decrease in FHR. Such a situation occurred in the case presented above, with resultant variable de...

show abstract

Antenatal diagnosis of fetal seizure activity with use of real-time ultrasound

Cited by 16 publications

References 4 publications

Changes in fetal motility as a result of congenital disorders: an overview

Changes in fetal motility as a result of congenital disorders: an overview

Fetal seizures: case report and literature review

Fetal grasping of the umbilical cord causing variable fetal heart rate decelerations

Contact Info

Product

Resources

About