Four‐dimensional sonographic assessment of fetal facial expression early in the third trimester

Abstract

Abstract Objective: To evaluate the characteristic patterns of facial expression in fetuses aged from 28 to 34 weeks using 4‐dimensional (4‐D) ultrasonography. Methods: The faces of 10 healthy fetuses aged from 28 to 34 weeks were recorded continuously for 15 min with a 4‐D ultrasonographic machine performing up to 25 frames per second. The occurrence rates of blinking, mouthing, yawning, tongue expulsion, smiling, scowling, and sucking were evaluated. Results: Mouthing was the most frequent facial expression (median, 6.5; range, 2–19) whereas the least frequent were scowling (median, 1; range, 0–9) and sucking (median, 1; range, 0–2). Mouthing was evident in all fetuses and significantly more frequent than any other movement ( P < .05). Yawning (median, 3; range, 0–6), smiling (median, 2; range, 0–9), and blinking (median, 1.5; range, 0–6) were observed in most cases. Tongue expulsion (median, 1.5; range, 0–5), scowling, and sucking were each observed in 6 cases. Conclusion: 4‐D sonography provides a means of evaluating fetal facial expression early in the third trimester. It may be a key to predicting fetal brain function and well‐being and an important modality in future fetal neurophysiologic research.