Neurobehavioral assessment of a syndromic Dandy-Walker malformation using 4D ultrasound and KANET: a case report

To evaluate fetal neurobehavior using the Kurjak Antenatal Neurodevelopmental Test (KANET) via 4D ultrasound in a fetus diagnosed with syndromic Dandy-Walker Malformation (DWM), and to correlate these findings with postnatal outcomes.

A 35-year-old woman was referred at 25 weeks' gestation for evaluation of multiple fetal anomalies. Ultrasound revealed hallmark DWM features - cerebellar vermis hypoplasia, enlarged posterior fossa, hydrocephalus - as well as extracranial anomalies including craniofacial dysmorphism, bilateral clubhands and clubfeet, and suspected hypoplastic left heart syndrome. A KANET assessment at 25+3 weeks yielded a severely abnormal score of 3. At 26 weeks, a male infant was delivered and survived 2 h postnatally. All anomalies were confirmed postnatally.

KANET, even when performed slightly earlier than standard timing, provided critical insights into the fetus's neurobehavioral function and correlated strongly with the fatal outcome. This case supports the value of KANET as a non-invasive tool for assessing neurological integrity in complex fetal conditions where third-trimester evaluation may not be possible.