Kurjak Antenatal Neurodevelopmental Test in Fetal Congenital Heart Defects: A Comparison of Antenatal and Postnatal Tests
Sertaç Esin, Nilay C Balci, Deniz A Ince, Emre Gunakan, Ozden Turan, İlknur E Dogan, Birgul Varan, Latife A Karakas, Meltem Aksu, Ilkay Erdogan, Niyazi K Tokel, Ayse Ecevit
Amiel-tison neurological assessment at term, Congenital heart defects, Fetal neurologic development, General movements assessment, Kurjak antenatal neurodevelopmental test
Citation Information :
Esin S, Balci NC, Ince DA, Gunakan E, Turan O, Dogan İE, Varan B, Karakas LA, Aksu M, Erdogan I, Tokel NK, Ecevit A. Kurjak Antenatal Neurodevelopmental Test in Fetal Congenital Heart Defects: A Comparison of Antenatal and Postnatal Tests. Donald School J Ultrasound Obstet Gynecol 2023; 17 (1):91-96.
Aim & Background: Kurjak's antenatal development test (KANET) have been developed and aimed to detect fetuses at high neurodevelopmental risk by four-dimensional (4D) ultrasound. Congenital anomalies are one of the most important causes of infant mortality, and CHD remain at the forefront. With abnormal development of the cardiac structures, decreased cerebral oxygen or substrate supply may place the developing fetus at risk for altered brain growth or brain injury.
Methods: In this study, we aimed to perform KANET test on fetuses with CHD in the antenatal period and Amiel-Tison (AT) test and General movements (GMs) in the postnatal period and compare antenatal and postnatal scores. Results: We have completed 38 KANET, 28 AT and 26 GMs tests in our cohort. Of thirty-eight infants who had KANET, median score was 15 (4–16). One patient (3%) had abnormal, 6 patients (16%) had borderline and 31 patients (81%) had normal scores. Five patients (18%) had minor, 14 patients (50%) had borderline and 9 patients (32%) had normal AT scores. Ten patients (38%) had normal and 16 (62%) patients had PR GMs scores. Of thirty patients who had normal KANET test scores, 25 patients had AT and 8 (32%) had normal, 4 (16%) had minor and 13 (52%) had borderline scores and 23 patients had GMs and 9 (39%) had normal and 14 (61%) had PR scores. There was only one patient with an abnormal KANET test. This patient's karyotype was turned out to be Trisomy 18. Antenatal KANET and postnatal AT and GMs test results were compared and there was no significant correlation between test results.
Conclusion: KANET has become a valuable functional test for identifying fetuses at high risk for various neurological impairments.
Clinical Significance: In our study, KANET test results were impressive and informative. Two trisomy 18 cases who died in the first day of life had lowest KANET test scores in our cohort. Thirty three percent of cases who had borderline scores at KANET resulted in postnatal exitus. Despite these results, most cases with moderate AT and PR GMs results had good outcomes according to follow up.
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