Fetal general movements and brain sonography in a population at risk for preterm birth

Dunne, Fidelma; Wezel‐Meijler, Gerda van; Bakker, M.; Odendaal, H. J.; Vries, J.I.P. de

doi:10.1016/j.earlhumdev.2010.01.026

Cited by 22 publications

(11 citation statements)

References 35 publications

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“…A third fetus showed reduced differentiation for the first time after 24 h. Quality assessment has been described as the most promising indicator of actual fetal well-being in various populations after birth [45,46]. Former research studied the quality of fetal movements in growth restricted fetuses [19], as well as the consistency of quality changes before and after birth in case of oligohydramnios [47] and preterm birth by either preeclampsia or labor [18]. In our trauma population abnormal quality of fetal movements was encountered in four fetuses within the 4-day post trauma period.…”

Section: Discussionmentioning

confidence: 99%

“…Acute, very intense maternal stress elicited by exposure to an earthquake has been described to induce hyperactive fetal movements during the first 8 h followed by inhibited motility over a few days, returning to normal after 72 h [16]. Fetal movements are specific and easily recognizable from their onset onwards throughout gestation, which makes them useful as indicator of the functioning of the CNS [17,18]. Fetal motility has previously been evaluated in several conditions [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Effect of (minor or major) maternal trauma on fetal motility: A prospective study

Knoop

Schie

Vermeulen

et al. 2015

Early Human Development

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of (minor or major) maternal trauma on fetal motility: A prospective study

Knoop

Schie

Vermeulen

et al. 2015

Early Human Development

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“…Based on this, it is not surprising that adverse pregnancy conditions, such as gestosis, FGR, famine during pregnancy (protein-energy malnutrition), and severe chronic maternal stress or depression have been linked to altered fetal movement patterns, echogenicity changes of the fetal brain, to higher incidence of neurodevelopmental disorders in childhood, and to occurrence of autism, schizophrenia, and epilepsy in the adult [1,3,5,9,12,16,32,40,41] .…”

Section: Fetal Behaviormentioning

confidence: 99%

Comparison between antenatal neurodevelopmental test and fetal Doppler in the assessment of fetal well being

Kurjak

Talić

Honemeyer

et al. 2012

Journal of Perinatal Medicine

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Aims: The primary aim of this study was to compare circulatory changes in the fetal brain under certain pathological conditions with alterations in fetal behavior. Patients and methods: A prospective longitudinal cohort study on fetal behavior of fetuses from singleton pregnancies between the 28 th and 38 th gestational week in the period from March 2009 to October 2011 was undertaken. There were 596 fetuses in the high-risk group and 273 fetuses in the low-risk group. Elevated umbilical artery Doppler pulsatility index and reduced middle cerebral artery pulsatility index obtained in the absence of fetal movements were considered abnormal. The Kurjak Antenatal Neurodevelopmental Test (KANET) was used to assess fetal behavior. Results: Statistically signifi cant differences in the distribution of normal, abnormal, and borderline KANET scores between low-risk and high-risk groups were found. Furthermore, 596 fetuses from the high-risk group were subdivided into subgroups according to the risk factor. The largest proportion of abnormal KANET scores (23.9 % ) was in the subgroup of fetuses whose mothers had an offspring diagnosed with cerebral palsy (23.9 % ), followed by the proportion of borderline KANET scores in the subgroup of fetuses from febrile mothers (12.7 % ). Fetal behavior was signifi cantly different between the normal group and the following subgroups of fetuses: fetal growth restriction (FGR), gestational diabetes mellitus, threatened preterm birth, antepartal hemorrhage, maternal fever, sibling with cerebral palsy, and polyhydramnios. Conclusions: A new clinical application of the KANET test in early identifi cation of fetuses at risk for adverse neurological outcome was demonstrated.

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“…Recent studies revealed that longitudinal evaluation of GMs and brain ultrasonography before and after birth in fetuses from pregnancies complicated by hypertensive disorders or preterm labor between 26 and 34 weeks gestational age may provide insight in the predictive value of fetal GMs for nervous system integrity and neurological outcome. 2 …”

Section: Postnatal Assessment Of Neonates After Fetal 4d Us Assessmenmentioning

confidence: 99%

“…[1][2][3] It has been suggested that the assessment of fetal behavior and developmental processes in different periods of gestation may make possible, the distinction between normal and abnormal brain development, as well as early diagnosis of various structural or functional abnormalities. 4 Four-dimensional ultrasound (4D US) or realtime three-dimensional ultrasound (3D US) offers a practical means for assessment of both the brain function and structure.…”

Section: Introductionmentioning

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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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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Fetal general movements and brain sonography in a population at risk for preterm birth

Cited by 22 publications

References 35 publications

Effect of (minor or major) maternal trauma on fetal motility: A prospective study

Effect of (minor or major) maternal trauma on fetal motility: A prospective study

Comparison between antenatal neurodevelopmental test and fetal Doppler in the assessment of fetal well being

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

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