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Intrauterine growth restriction and cerebral palsy
Asim Kurjak1, Maja Predojevic2, Milan Stanojevic3
1Department Of Obstetrics and Gynecology, University Hospital "Sveti Duh", Medical School, University Of Zagreb, Zagreb, Croatia ; Feto Maternal Medicine Unit, Women'S Hospital, Hamad Medical Corporation, Doha, Qatar.
Insights
Intrauterine growth restriction (IUGR) poses risks to fetal neurological development. A new 4D ultrasound scoring system, the Kurjak antenatal neurodevelopmental test (KANET), shows promise for assessing fetal neurological status.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Neurodevelopmental Pediatrics
Background:
- Intrauterine growth restriction (IUGR) is a common obstetric diagnosis associated with increased perinatal risks and lifelong health implications, particularly for neurological outcomes.
- Current fetal well-being assessments lack sufficient neurological evaluation, hindering the prediction of adverse neurological outcomes in at-risk fetuses.
- Fetal behavior is a reflection of central nervous system (CNS) maturation, suggesting that behavioral analysis can reveal CNS integrity.
Purpose of the Study:
- To introduce and evaluate the Kurjak antenatal neurodevelopmental test (KANET), a novel scoring system utilizing 4D sonography for assessing fetal neurological status.
- To explore the potential of 4D ultrasound in providing detailed insights into fetal behavior and prenatal CNS functional development.
- To determine the utility of KANET in identifying fetal brain and neurodevelopmental alterations resulting from early in-utero brain impairment.
Main Methods:
- Utilizing four-dimensional (4D) sonography to investigate detailed fetal behavior and development.
- Developing and applying the Kurjak antenatal neurodevelopmental test (KANET) scoring system for fetal neurological assessment.
- Analyzing preliminary data to gauge the effectiveness of KANET in detecting neurodevelopmental alterations.
Main Results:
- Four-dimensional (4D) sonography provides unprecedented detail on fetal behavior and CNS development.
- The proposed Kurjak antenatal neurodevelopmental test (KANET) offers a new method for assessing fetal neurological status.
- Preliminary findings suggest KANET is a promising tool for evaluating fetal brain health.
Conclusions:
- KANET, a 4D ultrasound-based scoring system, presents a novel approach to antenatal neurodevelopmental assessment.
- Further large-scale studies are needed to validate KANET's efficacy in distinguishing neurodevelopmental alterations in fetuses with early brain impairment.
- The preliminary results indicate KANET's potential to enhance the prediction of neurological outcomes in fetuses affected by intrauterine growth restriction.
Abstract:
Intrauterine growth restriction (IUGR) can be described as condition in which fetus fails to reach his potential growth. It is common diagnosis in obstetrics, and carries an increased risk of perinatal mortality and morbidity. Moreover, IUGR has lifelong implications on health, especially on neurological outcome. There is a need for additional neurological assessment during monitoring of fetal well-being, in order to better predict antenatally which fetuses are at risk for adverse neurological outcome. Studies have revealed that the behavior of the fetus reflects the maturational processes of the central nervous system (CNS). Hence, ultrasound investigation of the fetal behavior can give us insight into the integrity and functioning of the fetal CNS. Furthermore, investigations carried out using modern method, four-dimensional (4D) sonography, have produced invaluable details of fetal behavior and its development, opening the door to a better understanding of the prenatal functional development of the CNS. Based on previous observations and several years of investigation, our reaserch group has proposed a new scoring system for the assessment of fetal neurological status by 4D sonography named Kurjak antenatal neurodevelopmental test (KANET). The value of KANET in distinguishing fetal brain and neurodevelopmental alterations due to the early brain impairment in utero is yet to be assessed in large population studies. However, preliminary results are very encouraging.
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