Four-dimensional sonographic assessment of fetal movement in the late first trimester

Hata, Toshiyuki; Kanenishi, Kenji; Sasaki, Mutsuko

doi:10.1016/j.ijgo.2009.12.020

Cited by 23 publications

(11 citation statements)

References 15 publications

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“…12 However, other investigators noticed that the incidence of all fetal movements except for the startle movement increased with advancing gestational age, and the frequency of the startle movement remained unchanged in the first trimester of pregnancy. [13][14][15] Hata et al 16 found that the most frequent fetal movement was isolated arm movement at 10À11 GW, and jumping movement at 12-13 GW. There was a significant difference of jumping movement between 10-11 and 12-13 GW.…”

Section: First Trimestermentioning

confidence: 99%

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Hata

2016

J of Obstet and Gynaecol

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With the latest advent of four-dimensional (4-D) ultrasound, fetal neurobehavioral or neurodevelopmental assessment can be easily and readily performed. Using this technique, typical fetal movements and behavioral patterns have become apparent in all three trimesters of pregnancy. In twin pregnancy, 4-D ultrasound facilitates the precise evaluation of inter-twin contact and intra-pair stimulation. New fetal neurobehavioral assessment tests, such as Kurjak's Antenatal Neurodevelopmental Test and the Fetal Observable Movement System, may reflect the normal and abnormal neurological development of the fetus, and will facilitate more precise assessments of fetal neurobehavior or neurodevelopment, and fetal brain and central nervous system functions. In this review article, I also discuss interesting topics regarding maternal and fetal stress, fetal pain, and fetal consciousness. Four-dimensional ultrasound has opened the door to new scientific fields, such as 'fetal neurology' and 'fetal psychology,' and fetal neurobehavioral science is at the dawn of a new era. Knowledge on fetal neurobehavior and neurodevelopment will be advanced through fetal behavioral research using this technique.

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Section: First Trimestermentioning

confidence: 99%

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Hata

2016

J of Obstet and Gynaecol

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“…51 We are almost convinced that 4D US will find the place in everyday obstetrical practice, combining patient acceptance and sensitivity of diagnosis. [51][52][53][54] …”

Section: Advantages Of 4d Compared With 2d Ultrasound In the Assessmementioning

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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“…Moreover, the frequency of fetal movement patterns tended to increase at the beginning of the second trimester. Hata et al 51 evaluated the frequencies of 5 fetal movements (isolated arm, isolated leg, short trunk, long trunk, and jumping movements) in normal singleton pregnancies for 10 minutes at 10-11 and 12-13 weeks of gestation using 4D ultrasound. In the 17 pregnancies studied, the most frequent fetal movements were isolated arm movement at 10-11 weeks and jumping movement at 12-13 weeks.…”

Section: First and Early Second Trimestersmentioning

confidence: 99%

“…Further studies are needed to establish an acceptable level of inter-observer agreement regarding fetal movements. 51 "Presently, studying fetal behavior is very time-consuming, and, therefore, limited to research. An easier way of analyzing fetal behavior should be developed for diagnostic and prognostic use (e.g.…”

Section: Limitationsmentioning

confidence: 99%

Four-dimensional Ultrasound Evaluation of Fetal Neurobehavioral Development

Hata¹,

Kanenishi²,

Tanaka³

et al. 2010

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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The introduction of four-dimensional (4D) ultrasound techniques would facilitate fetal behavioral assessment in three-dimensions in realtime during pregnancy. We describe the latest 4D sonographic studies on fetal behavior, especially fetal whole-body movements and facial expressions in all three trimesters of pregnancy and the continuation of behavior from the fetal to neonatal period. Moreover, we introduce a new scoring system (KANET, Kurjak Antenatal Neurological Test) for assessment of the fetal neurological status using 4D ultrasound. 4D ultrasound also facilitated the evaluation of inter-human contact in twin pregnancies in utero. This novel technique may assist in the evaluation of fetal behavior and inter-twin contact, and offer potential advantages relative to conventional two-dimensional ultrasound. 4D ultrasound should become an important modality in future research on fetal neurobehavioral development and the prenatal identification of severely brain-damaged infants. Further studies involving a larger sample size are needed to ascertain the role of 4D ultrasound in the evaluation of fetal neurobehavioral development.

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Four-dimensional sonographic assessment of fetal movement in the late first trimester

Abstract: The difference in frequency of 5 fetal movements at 10-11 and 12-13 weeks of gestation may be caused by early neuromuscular development and differentiation of the neuromuscular system.

Cited by 23 publications

References 15 publications

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

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

Four-dimensional Ultrasound Evaluation of Fetal Neurobehavioral Development

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