Repeatability of the sonographic assessment of fetal sucking and swallowing movements

Levy, D. S.; Zielinsky, Paulo; Aramayo, Ana M.; Behle, Ivo; Stein, N.; Dewes, Lucas Otmar

doi:10.1002/uog.1868

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…Unlike that study which was based on experimental manipulation, the current observational result is based on longitudinal modeling techniques. Nonetheless, because amniotic fluid levels are regulated by fetal swallowing and micturition (Einspieler et al, 2012; Levy et al, 2005; Ross & Nijland, 1998), which are more common in active states, these findings suggest that more active fetuses are more active producers of amniotic fluid.…”

Section: Discussionmentioning

confidence: 99%

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DiPietro¹,

Costigan²,

Voegtline³

2015

Monographs Society Res Child

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Among the earliest volumes of this Monograph series was a report by Lester Sontag and colleagues, of the esteemed Fels Institute, on the heart rate of the human fetus as an expression of the developing nervous system. Here, some 75 years later, we commemorate this work and provide historical and contemporary context on knowledge regarding fetal development, as well as results from our own research. These are based on synchronized monitoring of maternal and fetal parameters assessed between 24 and 36 weeks gestation on 740 maternal-fetal pairs compiled from eight separate longitudinal studies, which commenced in the early 1990s. Data include maternal heart rate, respiratory sinus arrhythmia, and electrodermal activity and fetal heart rate, motor activity, and their integration. Hierarchical linear modeling of developmental trajectories reveals that the fetus develops in predictable ways consistent with advancing parasympathetic regulation. Findings also include: within-fetus stability (i.e., preservation of rank ordering over time) for heart rate, motor, and coupling measures; a transitional period of decelerating development near 30 weeks gestation; sex differences in fetal heart rate measures but not in most fetal motor activity measures; modest correspondence in fetal neurodevelopment among siblings as compared to unrelated fetuses; and deviations from normative fetal development in fetuses affected by intrauterine growth restriction and other conditions. Maternal parameters also change during this period of gestation and there is evidence that fetal sex and individual variation in fetal neurobehavior influence maternal physiological processes and the local intrauterine context. Results are discussed within the framework of neuromaturation, the emergence of individual differences, and the bidirectional nature of the maternal-fetal relationship. We pose a number of open questions for future research. Although the human fetus remains just out of reach, new technologies portend an era of accelerated discovery of the earliest period of development.

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Section: Discussionmentioning

confidence: 99%

Untitled

DiPietro¹,

Costigan²,

Voegtline³

2015

Monographs Society Res Child

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“…Various studies have reported real-time sonography as a reliable method for the evaluation of fetal movement, particularly fetal facial expressions, in the second and third trimesters. [26][27][28][29][30] These studies reported mouth opening in the context of swallowing, suckling, chewing, and even yawning 28 detected by real-time sonography in fetuses without abnormalities. According to these studies, continued observation by realtime sonography (for anywhere between 15 minutes and 2 hours, depending on the study) is a reliable and reproducible method for visualizing fetal mouth opening.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Imaging of Congenital Maxillomandibular Fusion

Vahidi

Joe

Glenn

et al. 2007

Journal of Ultrasound in Medicine

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“…At the same time fetal breathing movements, which cause fluid flow in the upper respiratory and digestive tracts and observed already in the 1 st trimester suggest that there has been proper growth and maturation of both the lower and upper tracts and their connections with the amniotic fluid cavity. Coordination of these reflexes appears and develops in intrauterine life and depends on appropriate development of anatomical structures of the respiratory and digestive tract structures as well as the nervous system [17]. It may account for more frequent episodes of regurgitation and irregularity of nasal fluid flow spectrum in younger fetuses, as the neural control mechanisms have not yet fully developed.…”

Section: Discussionmentioning

confidence: 99%

Assessment of nasal and oral flow of amniotic fluid in 46 non-anomalous fetuses with sonographic and echocardiographic examination

2018

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Objectives: The aim of the paper was to assess nasal and oral amniotic fluid flows, with the use of color ultrasound and spectral Doppler, in normal fetuses. Material and methods:Forty-six fetuses of singleton gestations were studied prospectively. Spectrum imaging and maximal nasal fluid flow velocities were described. Episodes of regurgitation (external flow from the mouth), swallowing (internal flow at the level of oropharynx and then entrance to the esophagus) were evaluated in two groups: Fetuses < 27 weeks of gestation and 27 weeks of gestation and older. Statistical analysis was done using Fischer exact test and t-test at p = 0.05.Results: Twenty-one fetuses were < 27 weeks of gestational age and presented mean maximal both inspiratory and expiratory nasal fluid flow velocities significantly lower than twenty-five fetuses who were ≥ 27 weeks of gestational age (p = 0.035 and p = 0.031 respectively, t-test). Episodes of regurgitation were observed more frequently in group of "younger" fetuses (p = 0.006, Fischer exact test). There was no statistically significant relationship between irregular nasal flow spectrum by color Doppler and gestational age group (p = 0.264, Fischer exact test). Conclusions:Episodes of regurgitation occurred in normal fetuses < 27 th week of gestation. Fast amniotic nasal fluid flows without episodes of regurgitation were observed more frequently in fetuses ≥ 27 weeks and it could be interpreted as an additional sonographic feature of prenatal maturation.

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Repeatability of the sonographic assessment of fetal sucking and swallowing movements

Cited by 8 publications

References 25 publications

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Prenatal Imaging of Congenital Maxillomandibular Fusion

Assessment of nasal and oral flow of amniotic fluid in 46 non-anomalous fetuses with sonographic and echocardiographic examination

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