Preeclampsia has a significant effect on maternal and fetal health, and in the most severe cases may lead to significant early or late-onset intrauterine growth restriction (IUGR), which can be diagnosed by ultrasound. In moderately severe and mild preeclampsia, the consequences for the fetus may be less severe. The main effect of preeclampsia on the fetus is malnutrition as the result of hypoxia due to uteroplacental vascular insufficiency, which occurs in approximately 30% of fetuses from preeclamptic pregnancies. This leads to various perinatal and neonatal complications including IUGR, emergency cesarean section (CS), premature birth, low birth weight, low APGAR scores, and often a longer stay in the neonatal intensive care unit and more severe acute respiratory distress syndrome after birth. The question is whether these consequences can be detected, and are there any indicators of early fetal distress before the development of growth restriction? Therefore, the aim is to investigate if observation of fetal behavior using four-dimensional ultrasound (4D US) in pregnancies with preeclampsia can reveal signs which could be added to existing diagnostic criteria for preeclampsia. The four-dimensional US offers the possibility of simultaneous visualization of real-time movements of the head, body, and all four extremities in three dimensions. Using the 4D US for assessment of fetal behavior and postnatal neuropediatric knowledge, a group from Zagreb proposed a prenatal screening test for assessment of the motor activity of the fetus, known as the Kurjak Antenatal Neurodevelopmental Test (KANET). The aim of the paper is to show that KANET is one of the most relevant tools for the assessment of fetal behavior, particularly in patients who are affected by preeclampsia. Based on our investigation we showed that preeclampsia clearly affects fetal behavior. The KANET test has proven to be a safe tool in assessing fetal neurodevelopment, especially in those at risk affected by severe preeclampsia. Prenatal fetal assessment is of great help to neonatologists in preparing for adequate and timely resuscitation procedures at birth. Low KANET scores always prompted close and intensive follow-up in pregnancies with severe preeclampsia to avoid adverse outcomes in both pregnant women and fetuses.
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