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

Mišković, Berivoj; Ahmed, Badreldeen; Younis, Moayyad; Abo-Yaquab, Salwa; Saleh, Huda; Shaddad, Afaf Naim; Bahar, Awatif Juma Al; Khenyab, Najat

doi:10.5005/jp-journals-10009-1076

Cited by 83 publications

(3 citation statements)

References 65 publications

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“…28 The primary outcome was the usefulness of KANET to identify fetuses from highrisk pregnancies at neurological risk. Then we want to compare the scores between the highrisk and lowrisk group and, also, compare the KANET results between the highrisk group and subgroups of fetuses.…”

Section: Methodsmentioning

confidence: 99%

KANET in Brazil: First Experience

Neto¹

2015

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Objective: The goal of this pilot test is to compare Kurjak's antenatal neurological test (KANET) results between high and low-risk pregnancies and see the feasibility of using this test on a larger scale in Brazil. Methods:We applied KANET test in high-risk (n = 17) and low-risk (n = 34) pregnancies and compared the results.Results: There was a significant difference between groups of high-risk and low-risk pregnancies for all parameters in KANET score 2. For KANET score 0, 5 out of 8 parameters where significant different: isolated head anteflexion, cranial sutures and head circumference, isolated hand movement or hand to face movements, isolated leg movement and fingers movements. All abnormal KANET result came from high-risk pregnancies (17.6%). No low-risk pregnancies presented KA-NET score 0. Efficacy and effectiveness were not evaluated due to the imprecision inherent in data from small samples. Conclusion:This successful preliminary study of KANET in Brazil showed important differences in fetal behavior between the low and high-risk pregnancies, and can be used as information of feasibility and identify modifications needed in the design of a larger testing study.

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Section: Methodsmentioning

confidence: 99%

KANET in Brazil: First Experience

Neto¹

2015

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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“…These results support growing evidence that many neurological disorders originate from intrauterine rather than peri-or postnatal periods. This makes a great difference for the obstetrician with regard to CP [38] , and is still one of the main causes of medico-legal confl icts, and might open new perspectives of prevention and therapy of neurodevelopmental disorders [1,20] .…”

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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“…KANET is the first prenatal neurological screening test based on the 4D ultrasound technique, whose preliminary results are promising. 55,[57][58][59][60][61] Nevertheless, its value in the assessment of integrity of the fetal central nervous system needs to be confirmed by studies that are in progress in several world university centers.…”

Section: Prenatal Neurological Assessmentmentioning

confidence: 99%

Fetal Brain Function: Lessons Learned and Future Challenges of 4D Sonography

Kurjak¹,

Predojević²,

Kadić³

2011

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Maturation of the central nervous system (CNS) is reflected in fetal behavior. Modern technology, such as four-dimensional (4D) sonography improved assessment of fetal behavior in all three trimesters of pregnancy. After summing our own experiences and experiences of the leading authors in the field of fetal and neonatal neurology, new prenatal screening test for assessment of fetal behavior has been suggested. Test was named Kurjak antenatal neurodevelopmental test (KANET). Up to now results of KANET are encouraging and they have been published in several prominent journals. Nevertheless, potential of KANET in the assessment of integrity of the fetal central nervous system needs to be confirmed by studies that are in progress in several world university centers.Keywords: Fetal brain development, Four-dimensional ultrasound, Neurological deficit, Perinatal neurological assessment. PRENATAL MORPHOLOGICAL AND FUNCTIONAL DEVELOPMENT OF THE FETAL CENTRAL NERVOUS SYSTEMDevelopment of the human central nervous system (CNS) begins in the early embryonic period and proceeds through a sequence of very complicated processes long after delivery. Early embryonic development is characterized by its immobility. Important prerequisite for fetal movements is the existence of the interneuronal and neuromuscular connections. The earliest interneuronal connections, the synapses, can be detected in the spinal cord shortly before the onset of embryonic motility, at 6 to 7 weeks of gestation.1 Therefore, the neural activity leading to the first detectable movements is considered to originate from the spinal motoneurons.2 As mentioned, another important prerequisite for the motility is the development and innervation of muscle fibers. It is well known that primitive muscle fibers (myotubes) are able to contract as soon as they are innervated by motor neurons.3 Between 6 and 8 weeks of gestation, muscle fibers have formed by fusion of myoblasts, efferent and afferent neuromuscular connections have developed, and spontaneous neural activity causing motility can begin. The first spontaneous embryonic movements are gross body movements and they can be observed at the 7 to 7.5th week of gestation. They consist of slow flexion and extension of the fetal trunk, accompanied by the passive displacement of arms and legs. These so-called vermicular movements appear in irregular sequences. Simultaneously with the onset of spontaneous movements, at the 7.5th week of gestation, the earliest motor reflex activity can be observed, indicating the existence of the first afferentefferent circuits in the spinal cord. The first reflex movements are massive and indicate a limited number of synapses in a reflex pathway. General movements are the first complex, wellorganized movement pattern, which involve head, trunk and limb movements. This pattern has been interpreted as the first sign of a supraspinal control on motor activity and can be recognized from 8 to 9 weeks of gestation onwards. 4 The brainstem is fashioned around the 7th week of gestati...

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

Cited by 83 publications

References 65 publications

KANET in Brazil: First Experience

KANET in Brazil: First Experience

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

Fetal Brain Function: Lessons Learned and Future Challenges of 4D Sonography

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