Assessment Of Fetal Neurobehavior Research Articles

Assessment of Fetal Neurobehavior in Special Cases

Assessment of Fetal Neurobehavior in Special Cases

The assessment of fetal neurobehavior by KANET test

The assessment of fetal neurobehavior by KANET test

The Assessment of Fetal Neurobehavior with Four-dimensional Ultrasound: The Kurjak Antenatal Neurodevelopmental Test

ABSTRACT Fetal neurology is an evolving field in prenatal diagnosis and fetal medicine with great interest. The identification and diagnosis of brain damage prenatally has been a great challenge in obstetrics for many years and early identification of this damage would have implications on the perinatal management and is of great importance in cases of medical litigation. Defining normal and abnormal fetal neurological function in utero in order to better predict antenatally which fetuses are at risk for adverse neurological outcome still is under investigation. Several attempts have been made in the past to form a system that could detect fetuses with compromised central nervous system (CNS) function or brain impairement. Assessment of fetal behavior gave a promising opportunity to understand the hidden function of the developmental pathway of the fetal CNS. The assessment of normal neurobehavioral development by fourdimensional (4D) ultrasound gave the opportunity to investigate functional characteristics of the fetus that could predict neurological developmental dysfunction. These series of studies lead to the formation of Kurjak's antenatal neurodevelopmental test (KANET). KANET combines the assessment of fetal behavior, general movements and three out of four signs that have been postnatally considered as symptoms of possible neurodevelopmental impairment (neurological thumb, overlapping sutures and small head circumference). Assessment of fetal behavior by 4D ultrasound and application of KANET scoring test has been recently published in several journals and summarized results are presented in this review How to cite this article Antsaklis P, Antsaklis A. The Assessment of Fetal Neurobehavior with Four-dimensional Ultrasound: The Kurjak Antenatal Neurodevelopmental Test. Donald School J Ultrasound Obstet Gynecol 2012;6(4):362-375.

4D Sonography in Assessment of Fetal Neurobehavior

ABSTRACT ‘Observation of fetal behavior reflects the functioning of the central nervous system, and behavioral assessment of the fetus enables the function of the brain to be examined’.1 The introduction of four-dimensional (4D) sonography techniques would facilitate fetal behavioral assessment in three dimensions in real time during pregnancy. We describe the latest 4D sonographic studies on fetal neurobehavior in all three trimesters of pregnancy. 4D sonography also facilitated the evaluation of interhuman contact and intrapair stimulation in twin pregnancies in utero. This novel technique may assist in the evaluation of fetal neurobehavior and intertwin contact and intrapair stimulation and offer potential advantages relative to conventional two-dimensional sonography. 4D sonography may become an important modality in future research on fetal neurobehavioral development and the prenatal identification of severely brain-damaged infants. How to cite this article Hata T, Sato M, Kanenishi K, Hanaoka U, Tanaka H. 4D Sonography in Assessment of Fetal Neurobehavior. Donald School J Ultrasound Obstet Gynecol 2012;6(2):121-131.

The role of 4-D ultrasonography in prenatal assessment of fetal neurobehaviour and prediction of neurological outcome

Objective. To determine the role of 4-D ultrasonography in prenatal assessment of fetal neurobehavior and in prediction of adverse neurological outcome.Design. Prospective cohort study.Setting. Women Hospital, Hamad Medical Corporation, Qatar.Population. Forty pregnant women between 20 and 38 weeks of gestation with high risk for neurological abnormalities and 40 low risk cases were included.Methods. Prenatal fetal neurological assessment using Kurjak antenatal neurodevelopmental test (KANET). Postnatal neurological assessment was performed using Amiel-Tison’s neurological assessment at term (ATNAT) for all live-borns.Main outcome measures. Prediction of fetuses at neurological risk.Results. The difference in the range of KANET score was significant. A significant difference was shown for isolated head anteflexion, isolated eye blinking, facial expressions, mouth movements, isolated hand movements, hand to face movement, finger movements, and general movements. For isolated leg movement and cranial sutures, the difference was not significant. All cases with abnormal KANET proved to be abnormal postnatally.Conclusion. 4-D ultrasonography may have an important role in prenatal assessment of fetal neurobehavior and prediction of adverse neurological outcome. However, further large studies are recommended before the test could be recommended for wider clinical practice.

The potential of 4D sonography in the assessment of fetal neurobehavior – multicentric study in high-risk pregnancies

An evolving challenge for obstetrician is to better define normal and abnormal fetal neurological function in utero in order to better predict antenatally which fetuses are at risk for adverse neurological outcome. Prenatal neurological assessment in high-risk fetuses using four-dimensional ultrasound applying the recently developed Kurjak antenatal neurodevelopmental test (KANET). Postnatal neurological assessment was performed using Amiel Tison's neurological assessment at term (ATNAT) for all live-borns and general movement (GM) assessment for those with borderline and abnormal ATNAT. Inclusion criteria were met by 288 pregnant women in four centers of whom 266 gave birth to a live-born baby. It was revealed that 234 fetuses were neurologically normal, 7 abnormal and 25 borderline. Out of 7 abnormal fetuses ATNAT was borderline in 5 and abnormal in 2, whereas GM assessment was abnormal in 5 and definitely abnormal in 2. Out of 25 KANET borderline fetuses, ATNAT was normal in 7, borderline in 17 and abnormal in 1, whereas the GM assessment was as follows: normal optimal in 4, normal suboptimal in 20, and abnormal in 1. In summary, out of 32 borderline and abnormal fetuses ATNAT was normal in 7, borderline in 22 and abnormal in 3; GM assessment was normal optimal in 4, normal suboptimal in 20, abnormal in 6 and definitely abnormal in 2. The sonographic test requires further studies before being recommended for wider clinical practice.

An Attempt to Introduce Neurological Test for Fetus Based on 3D and 4D Sonography

Abstract Fetal neurology is a new challenging field. Brain damage often originates in fetal life. Early identification of this damage has implications for perinatal management; moreover documentation of such lesions is essential in case of litigation. In the last two decades, fetal imaging with 2-dimensional ultrasounds and conventional magnetic resonance imaging have made a major contribution in the identification of classic brain lesions and malformations. However, it is only recently with diffusion weight imaging that the whole spectrum of perinatal white matter injuries has been described in the neonate. The recent advances of 3DUS and 4DUS in exploring fetal motor behavior should support a better clinical description of the full spectrum of fetal damage. New neurological test (KANET) of the fetus recently suggested by us (Kurjak et al 2008) might be helpful in the assessment of fetal neurobehavior.