Bizarre fetal behaviour associated with lethal congenital anomalies: a case report

Prolonged recording of behaviour was performed in a fetus at 36 weeks gestation, who was severely small for dates with no apparent aetiology. Detailed analysis of fetal behaviour was grossly abnormal. Behavioural states were absent and there were no intervals during which linkage of the state variables was demonstrated in a total of 120 min of observation. On repeated conventional biophysical testing the non-stress test was normal and the biophysical score was equivocal, varying from 4/10 to 8/10. Following delivery a lethal multiple congenital abnormality syndrome was identified. Close linkage of the fetal behavioural state variables is almost universal by this gestation, and has been associated with a good outcome in high-risk fetuses. Behavioural recordings may have a useful role in the evaluation of such fetuses, particularly where the aetiology is not apparent.