Chapter 32 - Antenatal fetal neurodevelopment test: KANET assessment

Abstract

The advancement in ultrasound technologies and development of four-dimensional ultrasound enabled precise evaluation of fetal movements and facial expressions. Kurjak proposed the antenatal neurodevelopmental score (KANET: Kurjak’s Antenatal Neurodevelopmental Test) based on some parameters of Amiel-Tison Neurological Assessment at Term (ATNAT) of newborn plus some fetal facial expressions and movements. The aim of this test was to observe fetal intrauterine neurobehavior and predict developmental disorders, which might cause neurological disabilities such as cerebral palsy later in life. The initial test was composed of 10 parameters based on multicenter studies, a standardization of this test was done, and the modified KANET was introduced composed of eight parameters. Several studies involving the application of KANET showed that ethnicity should be considered when certain neurobehavior is observed. However, the fetal sex may not affect the KANET results. KANET was also used to compare the neurobehavior of normal fetuses versus fetuses of high-risk pregnancies, twins, and fetuses of mothers on antipsychotic therapy. KANET was found to be useful for the prediction of postnatal developmental disabilities. Mini KANET using only three parameters was proposed, and initial studies showed diagnostic accuracies comparable with KANET. Therefore, KANET may be a useful diagnostic test to predict postnatal developmental disabilities in healthy and high-risk fetuses in utero. Mini KANET may become a simple antenatal fetal neurodevelopmental test instead of KANET in healthy fetuses.