Naslov
Perinatal monitoring: fetal wellbeing identification

Autori
Kurjak, Asim ; Stanojević, Milan ; Predojević, Maja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Preterm delivery: hypothesis and perspectives Rome (Italy), May 24th - 25th, 2011 / - , 2011, 66-67

Skup
International Congress on "Preterm delivery: hypothesis and prospectives"

Mjesto i datum
Rim, Italija, 24.05.2011. - 25.05.2011

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
fetal behavior; four dimensional ultrasound; prenatal monitoring; cerebral palsy

Sažetak
Fetal behavior refers to the fetal activities observed or recorded with ultrasonographic equipment. Behavior can be spontaneous, generated by the fetus itself, or elicited in response to external stimulus such as vibroacoustic stimulation. Analysis of the fetal dynamics in comparison with morphological studies has led to the conclusion that fetal behavioral patterns directly reflect developmental and maturational processes of the fetal central nervous system (CNS). In addition, there is a carryover effect of movements from prenatal to postnatal life. There were no movements observed in fetal life that were not present in neonatal life. Furthermore, prenatal-neonatal continuity exists even in subtle, fine movements such as facial mimics. Altered quality of fetal movements might reveal the structural or functional impairment of the fetal central nervous system. Improvement of four dimensional (4D) technology enabled introduction of Kurjak Antenatal Neurological Test (KANET), scoring test for the assessment of the fetal behavior. Our preliminary results have confirmed the usefulness of this test in fetal behavior assessment. The KANET test has potential to detect and discriminate normal from borderline and abnormal fetal behavior in normal and in high-risk pregnancies, which means that it could become a valuable diagnostic tool for fetal neurological assessment. Over 100 fetuses form pregnancies with threatened preterm labor have been studied using KANET in our multicentric program. Recently study with the largest number of fetuses (620 fetuses) where prenatal KANET test has been applied was published. Among the fetuses with abnormal KANET score, most frequently presented were fetuses from the threatened preterm delivery group. Preterm labor accounts for 75% of perinatal mortality and over 50% of perinatal morbidity. Although preterm survives, they are at increased risk of neurodevelopmental impairment. It has been shown that fetal behavior differs in preterm than term infants. Further, fetal behavior differs in neurologically compromised compared to normal fetuses. There are developmental differences between fetuses threatening to deliver early and other high risk fetuses. Preterm infants are at higher risk for cerebral palsy due to prematurity, intrauterine growth restriction, infection or multiple pregnancy. Pediatricians know that they need to wait until the age of 6 months postnatally to diagnose a severe CP and at least 24 months or even longer for a minor non-disabling CP. KANET test and behavioral assessment give new hope in the attempt of early diagnosis of cerebral palsy and provide identification of fetuses at neurological risk from pregnancies with threatened preterm labor.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA