Fetal behavioral and structural abnormalities in high risk fetuses assessed by 4D sonography

Ahmed, Badreldeen; Kurjak, Asım; Andonotopo, Wiku; Khenyab, Najat; Saleh, N.; Al-Mansoori, Zeena

doi:10.1080/14722240500386867

Cited by 14 publications

(3 citation statements)

References 27 publications

(63 reference statements)

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“…However, in intermediate situations the quality of observations achieved by 3D/4D US already allows to demonstrate the prenatal onset of brain damage, based on morphologic and functional signs. 26,27 Their identification during the second half of pregnancy may serve as a retrospective marker of a prenatal insult.…”

Section: Fetal Origin Of Neonatal Behaviormentioning

confidence: 99%

“…In other words, behavioral study of the fetus will be necessary to understand the origins of motor and sensory capabilities of infants and the mechanisms of altered developmental outcomes. 27 Awareness of changing risks and impending of significant neurodevelopmental problem is an essential principle of perinatal medicine. Unfortunately, adverse neurological outcomes can develop after failure to timely recognize CNS developing risk and timely referral of individuals to the appropriately staffed facility.…”

Section: Fetal Behavior As An Indicator Of Fetal Brain Impairmentmentioning

confidence: 99%

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An Attempt to Standardize Kurjak's Antenatal Neurodevelopmental Test: Osaka Consensus Statement

Stanojević¹,

Talić²,

Mišković³

et al. 2011

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Analysis of the dynamics of fetal behavior in comparison with morphological studies has led to the conclusion that fetal behavioral patterns are directly reflecting developmental and maturational processes of fetal central nervous system (CNS). Four-dimensional ultrasound (4D US) offers a practical means for assessment of both the brain function and structure. The visualization of fetal activity in utero by 4D US could allow distinction between normal and abnormal behavioral patterns which might make possible the early recognition of fetal brain impairment. That new technology enabled introduction of Kurjak's antenatal neurodevelopmental test (KANET) in low-and high-risk pregnancies. In order to make the test reproducible, the standardization of the test was proposed in Osaka, Japan, during the International Symposium on Fetal Neurology of International Academy of Perinatal Medicine.The KANET should be performed in the 3rd trimester from 28th to 38th week of gestation. The assessment should last from 15 to 20 minutes, and the fetuses should be examined when awake. If the fetus is sleeping, the assessment should be postponed for 30 minutes or for the next day between 14 and 16 hours. In cases of definitely abnormal or borderline score, the test should be repeated every two weeks till delivery. New modified KANET test should be used with eight instead of 10 parameters: Facial and mouth movements are combined in one category, isolated hand movements and hand to face movements are combined in one category. The score should be the same for abnormal fetuses 0 to 5, borderline score is from 6 to 13 and normal score is 14 or above.After 4D US assessment of behavioral patterns in the fetuses from high-risk pregnancies, it is very important to continue with follow-up after delivery in infants who were borderline or abnormal as fetuses. Postnatal assessment of neonates includes initial neurological assessment according to Amiel-Tison's methodology (Amiel-Tison Neurological Assessment at Term, ATNAT) in the early neonatal period and every two weeks in preterm infants till discharge and at the postmenstrual age (PMA) between 37 and 40 weeks. If ATNAT is borderline or abnormal, initial assessment of general movements at the age of 36 to 38 weeks of PMA should be performed, than at writhing age (between 46 and 52 weeks), and at the fidgety age after 54 weeks of PMA. If the finding of fidgety movements is mildly abnormal or definitely abnormal, then one more assessment should be done in 2 to 4 weeks till PMA of 58 weeks. Brain ultrasonography should be performed in the first week of life and every 2 weeks afterward till discharge. In severely affected infants with grade 3 and above intraventricular hemorrhage, and those highly suspicious of hypoxic ischemic brain damage, magnetic resonance (MR) should be done if available. Infants should be followed until the age of at least 24 months when diagnosis of disabling or nondisabling cerebral palsy can be ultimately made. Infants with CP should be reassessed at the age of 6 years.

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Section: Fetal Origin Of Neonatal Behaviormentioning

confidence: 99%

Section: Fetal Behavior As An Indicator Of Fetal Brain Impairmentmentioning

confidence: 99%

An Attempt to Standardize Kurjak's Antenatal Neurodevelopmental Test: Osaka Consensus Statement

Stanojević¹,

Talić²,

Mišković³

et al. 2011

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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“…There have been only two case reports on 4D sonographic assessments of singleton anencephalic fetuses before 20 weeks of gestation [8,9]. All movement pattern frequencies in the anencephalic fetuses at 11 weeks' gestation were decreased compared with those in normal fetuses in the first trimester [8].…”

mentioning

confidence: 99%

Inter-twin contact in a case of monochorionic diamniotic twins with acrania of one twin fetus at 10–13 weeks’ gestation

et al. 2011

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Anencephaly can be reliably diagnosed using ultrasound late in the first trimester of pregnancy [1]. The prevalence of anencephaly in twins is higher than that in singleton pregnancies, and the prevalence of discordance in anencephaly in monochorionic twins is higher than that in dichorionic twins [2].There have been only two reports on conventional twodimensional (2D) sonographic assessment of fetal behavior in twins discordant because of anencephaly after 20 weeks of gestation [3,4]. However, there has been no report on four-dimensional (4D) sonographic assessment of intertwin contact in twins discordant because of anencephaly in utero. To the best of our knowledge, this is the first report on 4D sonographic assessment of inter-twin contact in a case of monochorionic diamniotic (MD) twins with acrania of one twin fetus late in the first trimester.A 28-year-old Japanese woman, gravida 3, para 1, visited our hospital because of secondary amenorrhea, and MD twin pregnancy at 7 weeks and 4 days was diagnosed. At 11 weeks and 4 days, twin pregnancy with acrania of one twin fetus was diagnosed (Fig. 1). The parents were informed about the lethality of the affected twin fetus, but they elected to continue the pregnancy. At 25 weeks and 1 day, she was admitted to our hospital because of threatened premature labor (short cervix and irritable uterine contractions). At 38 weeks and 4 days, the first of two female infants (anencephalic twin), weighing 1,948 g, and the other infant (second twin), weighing 2,372 g (Apgar score 7 at 1 min and 9 at 5 min; umbilical artery blood pH 7.089), were delivered by elective cesarean section because of two previous cesarean sections. The anencephalic twin died soon after delivery. Permission to conduct an autopsy was not granted by the parents. The second twin is doing well.Detailed descriptions of the data-collecting methods and measurement procedures used in this patient have been presented in a previous publication [5]. In brief, examinations were performed for 30 min with transabdominal 4D sonography at 11 weeks and 4 days and 13 weeks and 1 day of pregnancy, respectively. She was asked whether she would agree to a 30-min observation of fetal movements and inter-twin contact after undergoing routine sonographic examinations. This study was approved by the local ethics committee of Kagawa University School of Medicine, and standardized written informed consent was obtained from the patient. All 4D examinations were performed using Voluson 730 Expert (GE Medical Systems, Milwaukee, WI) with a transabdominal 2-5-MHz transducer. Ten types of inter-twin contact (head to head, head to arm, head to trunk, head to leg, arm to arm, arm to trunk, arm to leg, trunk to trunk, trunk to leg, and leg to leg) were analyzed during playback of the video recordings. The total number of all inter-twin contacts was determined by a single experienced observer (M.S.) and compared to the quartile range obtained from normal MD twins [5]. The frequencies of ten types of inter-twin contact were also compared ...

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Aerodigestive and communicative behaviors in anencephalic and hydranencephalic infants

Radford

Taylor

Hall

et al. 2018

Birth Defects Research

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The aerodigestive and communicative behaviors of anencephalic and hydranencephalic patients are assessed from literature sources and are compared with documented neural structures present in the brainstem, subcortical, and cortical regions of the brain. Much of the data analyzed corroborate previous neurological studies, which focus on central pattern generators and development in model organisms. However, findings suggest that further research is necessary to determine which components of these systems support these behaviors. A low reporting rate of behavior in tandem with pathology is observed throughout the literature. More data pairing behavior and pathology is recommended, both in the interest of understanding the relationship between neural structures and functions, and to provide clinicians with more information about a patient's signs and symptoms. Potential clinical practices are recommended to increase documentation about patients within this population.

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Fetal behavioral and structural abnormalities in high risk fetuses assessed by 4D sonography

Cited by 14 publications

References 27 publications

An Attempt to Standardize Kurjak's Antenatal Neurodevelopmental Test: Osaka Consensus Statement

An Attempt to Standardize Kurjak's Antenatal Neurodevelopmental Test: Osaka Consensus Statement

Inter-twin contact in a case of monochorionic diamniotic twins with acrania of one twin fetus at 10–13 weeks’ gestation

Aerodigestive and communicative behaviors in anencephalic and hydranencephalic infants

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