Spontaneous motor activity in normal fetuses

D’Elia, A; Pighetti, M; Moccia, G; Santangelo, Nicoletta

doi:10.1016/s0378-3782(01)00224-9

Cited by 85 publications

(61 citation statements)

References 12 publications

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“…[25][26][27] We optimized an MR imaging sequence to capture fetal movements throughout the whole body from GA 18 weeks to term. We observed a consistent repertoire of movements throughout this GA range.…”

Section: Discussionmentioning

confidence: 99%

“…Our results showed the same trend, but the movement frequency was 30% at GA 24 weeks and 4% at GA 36 weeks (Fig 4). It was hypothesized that the decrease in movement frequency could be, in part, attributable to decreased intrauterine space, 25 with the establishment of behavior states after GA 30 weeks being a separate contributory factor. 28 We found a statistically significant decrease in movement frequency with increased volumetric occupancy of the uterus (Fig 8), such that near term, the fetus occupied approximately 90% of the intrauterine volume, double that at GA 20 weeks.…”

Section: Figmentioning

confidence: 99%

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Optimization and Initial Experience of a Multisection Balanced Steady-State Free Precession Cine Sequence for the Assessment of Fetal Behavior in Utero

Hayat¹,

Nihat²,

Martinez‐Biarge³

et al. 2010

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The assessment of motor function is an essential component of neurologic examinations, which imaging studies have extended to the fetus. US assessment is hampered by a limited FOV, whereas MR imaging has the potential to be an alternative. Our objectives were to optimize a cine MR imaging sequence for capturing fetal movements and to perform a pilot analysis of the relationship between the frequency of movements and uterine spatial constrictions in healthy fetuses.

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Section: Discussionmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

Optimization and Initial Experience of a Multisection Balanced Steady-State Free Precession Cine Sequence for the Assessment of Fetal Behavior in Utero

Hayat¹,

Nihat²,

Martinez‐Biarge³

et al. 2010

AJNR Am J Neuroradiol

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“…The number of general body movements, which tends to increase from the 9th week onwards, gradually declines during the last 10 weeks of the pregnancy. [11][12][13] Although this decrease was first explained as a consequence of the decrease in amniotic fluid volume, it is now considered to be a result of cerebral maturation processes. As the medulla oblongata matures, myelinates and stabilizes, these spontaneous movements are less easily triggered and begin to be controlled by more stable intrinsic activities generated within the brainstem.…”

Section: Prenatal Morphological and Functional Development Of The Fetmentioning

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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“…15 Although this decrease was first explained as a result of the reduction in amniotic fluid volume, it is now believed to be a result of maturation processes in the brainstem. 12 Simultaneously with the decline in the number of generalized movements, an increase in facial movements, as well as opening or closing of the jaw, swallowing and chewing, can be observed.…”

Section: The Origin Of Fetal Behavior and Fetal Motor Development Assmentioning

confidence: 99%

“…These activities can be seen mainly in the periods of absence of general movements, and this pattern is considered to be a manifestation of the normal neurological development of the fetus. 15 However, alterations not only in the number of movements, but also in their complexity, are revealed to be the result of cerebral maturation processes. It is important to point out that subunits of the brainstem remain the main regulators of all fetal behavioral patterns until delivery.…”

Section: The Origin Of Fetal Behavior and Fetal Motor Development Assmentioning

confidence: 99%

Fetal Neurology—Lesson Learned and Future Challenges

Mišković¹,

Azumendi²,

Kurjak³

et al. 2007

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Neurological failure is the most apprehension complication of pregnancy, labor and the neonatal period. The origin and outcome correlation is frequently doubtful. The arrival of four-dimensional ultrasonography (4D US) and its function to study fetal behavior patterns have initiated to offer insight into the structural and functional fetal brain development. Although many fetal behavioral studies have been conducted, it is still questionable whether the assessment of continuity from fetal to neonatal behavior could improve our ability of early detection of brain pathology. Neurological assessment of fetus in utero is extremely difficult even having such sophisticated equipment like 4D ultrasound. As it is well known that quantity of GMs is not so informative and predictive for neurological impairment, their quality should be assessed. Gestalt perception of premature GMs we are dealing with in utero and several weeks postnatally are not as predictive for the detection of neurologically abnormal fetuses or newborns as fidgety GMs. Therefore some additional parameters should be added to the prenatal neurological examination in order to improve our ability to make the distinction between normal and abnormal fetuses.

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Spontaneous motor activity in normal fetuses

Cited by 85 publications

References 12 publications

Optimization and Initial Experience of a Multisection Balanced Steady-State Free Precession Cine Sequence for the Assessment of Fetal Behavior in Utero

Optimization and Initial Experience of a Multisection Balanced Steady-State Free Precession Cine Sequence for the Assessment of Fetal Behavior in Utero

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

Fetal Neurology—Lesson Learned and Future Challenges

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