The role of 4-D ultrasonography in prenatal assessment of fetal neurobehaviour and prediction of neurological outcome

Abstract

OBJECTIVE: To determine the role of 4-D ultrasonography in prenatal assessment of fetal neurobehavior and in prediction of adverse neurological outcome. DESIGN: Prospective cohort study. SETTING: Women Hospital, Hamad Medical Corporation, Qatar. POPULATION: Forty pregnant women between 20 and 38 weeks of gestation with high risk for neurological abnormalities and 40 low risk cases were included. METHODS: Prenatal fetal neurological assessment using Kurjak antenatal neurodevelopmental test (KANET). Postnatal neurological assessment was performed using Amiel-Tison's neurological assessment at term (ATNAT) for all live-borns. MAIN OUTCOME MEASURES: Prediction of fetuses at neurological risk. RESULTS: The difference in the range of KANET score was significant. A significant difference was shown for isolated head anteflexion, isolated eye blinking, facial expressions, mouth movements, isolated hand movements, hand to face movement, finger movements, and general movements. For isolated leg movement and cranial sutures, the difference was not significant. All cases with abnormal KANET proved to be abnormal postnatally. CONCLUSION: 4-D ultrasonography may have an important role in prenatal assessment of fetal neurobehavior and prediction of adverse neurological outcome. However, further large studies are recommended before the test could be recommended for wider clinical practice.