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

TLDR

Further large studies are needed before 4‑D ultrasonography can be recommended for routine clinical use. The study aimed to determine the role of 4‑D ultrasonography in prenatal assessment of fetal neurobehavior and in predicting adverse neurological outcomes. A prospective cohort of 80 pregnant women (40 high‑risk, 40 low‑risk) at Hamad Medical Corporation, Qatar, was evaluated prenatally with the Kurjak antenatal neurodevelopmental test (KANET) and postnatally with the Amiel‑Tison neurological assessment at term (ATNAT) to assess neurobehavioral differences. Significant differences were found in head anteflexion, eye blinking, facial expressions, mouth, hand, finger, and general movements, while leg movement and cranial sutures did not differ; all abnormal KANET cases were abnormal postnatally, indicating that 4‑D ultrasonography predicts adverse neurological outcomes.

Abstract

To determine the role of 4-D ultrasonography in prenatal assessment of fetal neurobehavior and in prediction of adverse neurological outcome.Prospective cohort study.Women Hospital, Hamad Medical Corporation, Qatar.Forty pregnant women between 20 and 38 weeks of gestation with high risk for neurological abnormalities and 40 low risk cases were included.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.Prediction of fetuses at neurological risk.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.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.