Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 5 , ISSUE 2 ( April-June, 2011 ) > List of Articles

REVIEW ARTICLE

Continuity from Fetal to Neonatal Behavior: Lessons Learned and Future Challenges

Milan Stanojevic

Keywords : Development of central nervous system,Fetal neurobehavior,Four-dimensional ultrasound,General movements,Neonatal neurobehavior

Citation Information : Stanojevic M. Continuity from Fetal to Neonatal Behavior: Lessons Learned and Future Challenges. Donald School J Ultrasound Obstet Gynecol 2011; 5 (2):107-118.

DOI: 10.5005/jp-journals-10009-1185

License: CC BY-NC 4.0

Published Online: 00-06-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Understanding the relation between fetal and infant behavior and developmental processes of the brain in different periods of gestation may make achievable the distinction between normal and abnormal brain development as well as the early diagnosis of various structural or functional abnormalities. As the development of the brain is unique and continuing process throughout the gestation and after birth, it is expected that there is also continuity of fetal and neonatal behavior, which is the best functional indicator of developmental processes of the brain.

The aim is to present continuity of the general and other movements from prenatal to postnatal life in fetuses and newborns from low- and high-risk pregnancies.

Epidemiological studies revealed that many neurologically impaired infants belong to low-risk population, which means that they seemed to be developmentally normal as fetuses and as infants, while later in childhood neurological disability was diagnosed. Dyskinetic cerebral palsy (CP) is the dominant type of CP found in term-born, appropriate-for-gestational-age children with severe impairments who have frequently experienced adverse perinatal events. As neuroprotective methods of treatment are available for some infants, simple screening methods could be helpful to detect impaired fetuses early enough in order to avoid developmental catastrophe. It has been clear from postnatal assessment of Prechtl's neonatal general movements (GMs) that it is a better predictor of neurodevelopmental disability than neurological examination. Introduction of two-dimensional (2D) and four-dimensional (4D) ultrasound enabled introduction of GMs assessment to the prenatal period. Kurjak et al conducted a study by 4D ultrasound and confirmed earlier findings made by 2D ultrasonography, that there is behavioral pattern continuity from prenatal to postnatal life. New antenatal neurological screening test has been introduced by Kurjak et al (KANET), which was postnatally followed by postnatal neurological screening assessment according to Amiel-Tison (ATNAT). Although many fetal behavioral studies have been conducted in low- and high-risk pregnancies and KANET has been recently standardized, it is still questionable whether the assessment of continuity from fetal to neonatal behavior could improve ability for early detection of brain pathology.


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