Common fetal reflexes include hiccuping and yawning. In the second and third trimesters, these reflexes are easily seen, and can be documented in any fetus if ultrasonographic examination is prolonged. If observed in the sagittal plane, the diaphragm may be seen moving caudad with the yawn; a full yawn sequence is characterized by a number of small mouth openings, each with concomitant mild neck extension, just prior to the full yawn, with maximal and prolonged jaw extension and extension of the neck, followed flexion at the end of the reflex, as occurs in children and adults. Similarly, hiccuping is easily seen in the second and third trimester, the sternum suddenly retracting concomitant with caudad diaphragmatic movement, and is commonly observed in an extended ultrasound. I have determined that both of these reflexes occur in the first trimester—documenting hiccuping at 10 weeks, and yawning sequence at 11 weeks, captured on videotape. The fact that these reflexes are present and active in the first trimester likely is not by chance. From an evolutionary biological perspective, such early expression of a reflex suggests that it has a selective advantage. Since all mammals yawn, as do reptiles and birds, the reason must be pan-species. The reflexes are disinhibited in the decerebrate adult. These reflexes may be necessary for the normal development of the airway passages during organogenesis in the first trimester, helping to prevent bronchial and tracheal webs. Bronchial webs may lead to focal adenomatous malformation of the lung. Should a tracheal web occur, the evolutionary fitness for that individual is 0, since the organism would die at birth. Both reflexes would serve to dislodge potential webs from formation through hydraulic pressure variation. Any anatomic anomaly which would interfere with normal flow prenatally (then liquid flow) would predispose towards tracheal webs and neonatal death—as in a neonate who died of asphyxia last year, whom I found at autopsy affected with Treacher Collins syndrome and a tracheal web. Hence, the reason why we yawn and hiccup is simply because we had to do it in the first trimester to assure patent airway development, and postnatlly the reflexes just keep going.
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