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

Abstract

Objective: 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. Patients and methods: 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. Results: 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

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

“…57 This multicentric research included 228 fetuses from high-risk pregnancies, of whom 18 had definite abnormal KANET score. 57 Of these 18 pregnancies, five pregnancies were terminated and six fetuses died in utero.…”

“…57 This multicentric research included 228 fetuses from high-risk pregnancies, of whom 18 had definite abnormal KANET score. 57 Of these 18 pregnancies, five pregnancies were terminated and six fetuses died in utero. Of seven fetuses with abnormal KANET, postnatal neurological assessment by Amiel Tison's method revealed three newborns out of seven fetuses to be abnormal (arthrogryposis, vermis aplasia and neonate of the mother with the previous child with CP), while four were considered normal (ventriculomegaly, pre-eclampsia, thrombophylia, oligohydramnios).…”

“…Of seven fetuses with abnormal KANET, postnatal neurological assessment by Amiel Tison's method revealed three newborns out of seven fetuses to be abnormal (arthrogryposis, vermis aplasia and neonate of the mother with the previous child with CP), while four were considered normal (ventriculomegaly, pre-eclampsia, thrombophylia, oligohydramnios). 57 The three very illustrative cases with abnormal KANET scoring were arthrogryposis, vermis aplasia, and the fetus whose previous sibling had verified cerebral palsy. The fetuses in these three cases had especially reduced facial movements, the faces were like mask during repeated scans.…”

“…The gestalt perception of GMs was also abnormal in these cases. 57 In this study, the behavior of a fetus with acranius was also longitudinally followed. 57 It has been observed that the fetus at 20 weeks of gestation had hypertonic movements with high amplitude and high speed.…”

Recent Results of the Clinical Application of Kanet Test

“…The authors concluded that there is a potential for the prenatal detec tion of serious neurological disorders. 55 also in 2010, Miskovic et al applied KaNeT in 226 high-and low-risk pregnancies and compared the results. They found three cases of abnormal KaNeT with chromosomal abnormalities, which had also abnormal aTNaT.…”