engleski

The new imaging method to assess the functional development of fetal central nervous system

Ultrasonic imaging of fetal intrauterine activities in a real time has provided invaluable information about the most important events in the functional development of human central nervous system. Analysis of the dynamics of fetal behavior has lead to the conclusion that fetal behavioral patterns directly reflect developmental and maturational processes of fetal central nervous system. Therefore, it has been suggested that the qualitative assessment of fetal behavior could be used for the evaluation of the integrity of fetal CNS and possibly, for the detection of functional or structural brain disorders. The new, advanced imaging techniques, three-dimensional (3D) and four-dimensional (4D) sonography have opened a new perspective for the studying of fetal neurodevelopment. Our results indicate that in early pregnancy, 3D sonography provides the additional morphological information, which could facilitate the early detection of the serious neurodevelopmental malformations, such as spina bifida. Furthermore, we have shown that even in the first trimester of pregnancy, quantitative analysis of most fetal movement patterns can be performed by 4D sonography with the same accuracy as using the real time two-dimensional (2D) sonography. The application of 4D sonography in the examination of fetal facial movements in the third trimester of pregnancy has revealed the existence of a full range of facial expressions, similar to emotional expressions in adults, which could not be visualized by 2D sonography. The comparison of facial movements in the near-term fetuses, recorded by 4D sonography, with the neonatal movements has shown the existence of prenatal-neonatal continuity. Namely, we found no statistically significant difference in the quality or quantity of fetal and neonatal facial movements. There were no movements observed in fetal life that were not present in neonatal life, whereas Moro reflex was present only in neonates. Application of 4D sonograpy might improve the qualitative assessment of fetal behavioral patterns and facilitate the development of diagnostic strategies for early detection or prevention of brain dysfunctions. The importance of these investigations is underlined by the recent findings that many environmental influences causing the fetal stress can interfere with the fetal neurodevelopment and leave the long term and profound consequences on brain structure and function.

fetal behavior; neurodevelopment; 4D ultrasound

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