engleski

New data about fetal neurodevelopment and behavior obtained by 4D sonography

The development of human central nervous system (CNS) starts at the very beginning of the prenatal life, proceeds through a sequence of very complicated developmental processes during all trimesters of gestation, and does not end until late after birth. The early sonographic studies of fetal intrauterine activities have shown that these processes are rather precisely reflected in the fetal behavioral patterns. It has been suggested that the assessment of fetal behavior coul 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 technique such as 4-dimensional (4D) sonography, opened a new perspective fot the investigation of fetal neurodevelopment. Our results indicate that even in the first trimester of pregnancy, quantitative analysis of most fetal movement patterns can be perfomed by 4D sonography with the same accuracy as using the real time two-dimensional (2D) sonography.The qualitative assessment might be even more informative because this method allows the simultaneous visualization of the whole fetal body. Our recent longitudinal study, perfomed on 100 fetuses in all trimesters of normal pregnancies has shown increasing frequency of the fetal movements during the first trimester. The declining trend in frequency of fetal body and limb movements from second to third trimesters have been noticed. All types of facial expression patterns display the peak frequency at the end of second trimester, exept in isolated eye blinking which began to increase at the beginning of 24 weeks. During the third trimester, the fetuses began to display decreasing or stagnantly of incidence of fetal facial expressions. 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. The application of 4D sonography might improve the assessment of fetal behavioral patterns, as well as our understanding of the prenatal neurodevelopment, and possibly facilitate the development of diagnostic strategies for early detection or prevention of brain dysfunctions and damage. 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 cosequences on brain structure and function.

fetal CNS; neurodevelopment; behavioral patterns; 4D sonography

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