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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
The fetal neurologist: Strategies to improve training, practice, and clinical care
Tally Lerman-Sagie1,2, Anthony R Hart3
1Multidisciplinary Fetal Neurology Center, Fetal Brain Research Center, Obstetrics-Gynecology Ultrasound Unit and Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel.
Insights
Fetal neurologists diagnose and counsel parents on fetal brain anomalies using imaging. Specialized training and multidisciplinary teams are crucial for effective care and understanding long-term outcomes.
Area of Science:
- Fetal neurology
- Neurodevelopmental disorders
- Prenatal diagnosis
Background:
- Fetal neurology focuses on counseling parents regarding fetal brain anomalies.
- Diagnoses are made via imaging and diagnostic studies, as direct infant examination is impossible.
- Common anomalies include disruptive lesions, genetic cortical malformations, and posterior fossa abnormalities.
Purpose of the Study:
- To highlight the essential role of fetal neurologists in prenatal diagnosis and parental counseling.
- To emphasize the need for specialized training and multidisciplinary collaboration in fetal neurology.
- To advocate for comprehensive service designs for consistent and effective family care.
Main Methods:
- Review of current practices and literature in fetal neurology.
- Discussion of diagnostic approaches using imaging and other studies.
- Emphasis on the integration of fetal neurologists into multidisciplinary teams.
Main Results:
- Fetal neurologists provide critical prognostication for various fetal brain anomalies.
- Early identification of anomalies and thorough parental counseling are key.
- Multidisciplinary team integration improves cohesive care for families.
Conclusions:
- Specialized training and collaborative efforts are vital for fetal neurologists.
- Comprehensive service models are needed for optimal care delivery.
- Fetal neurologists play a critical role in informing parents about prognosis and outcomes.
Abstract:
Fetal neurology addresses counselling parents on the clinical significance of brain anomalies encountered in their fetus, including disruptive lesions (i.e. stroke, periventricular haemorrhagic infarction, and infection), and genetically based cortical (i.e. hemimegalencephaly, lissencephaly, cobblestone malformation, polymicrogyria, heterotopia) or posterior fossa anomalies (i.e. cerebellar agenesis and hypoplasia, rhombencephalosynapsis, Dandy-Walker syndrome, mega cisterna magna, Blake's pouch cyst). Unlike paediatric neurologists, fetal neurologists cannot examine the infant directly so they diagnose and prognosticate using imaging and other diagnostic studies. The integration of fetal neurologists into fetal multidisciplinary teams is essential for providing expert counselling and cohesive care. This review emphasizes the need for specialized training, multidisciplinary collaboration, and the development of comprehensive service designs to ensure consistent and effective care for families. Additionally, it emphasizes the critical role of fetal neurologists in identifying brain anomalies early and providing thorough counselling to parents, helping them to understand the prognosis, potential interventions, and long-term outcomes for their unborn child.
