Neurodevelopmental fetal assessment using KANET scoring system in low and high risk pregnancies

Abstract

Objective: To assess and compare fetal behavior and neurodevelopment (KANET) between low and high risk pregnancies. Methods: Prospective, comparative, cohort study. One hundred and fifty-two consecutive pregnant women presenting for routine 2nd trimester and 3rd trimester scan had four dimensional ultrasound examinations (4D US) in order to assess fetal behavior and neurodevelopment. This was achieved by the study of: (1) isolated head movements, (2) isolated hand movements, (3) isolated leg movements, (4) cranial sutures, (5) hand to face/head movements, (6) finger movements, (7) yawning – mouthing, (8) facial expressions, (9) isolated eye blinking, (10) “Gestalt” perception. According to the maternal background risk, the population of the study was classified in low risk pregnancies (n = 78) and high risk pregnancies (n = 74) with IUGR fetuses (n = 12), diabetes mellitus (n = 24), and pre-eclampsia (n = 38). Results: The neurodevelopmental score was statistically significant higher in the low risk group compared to the high risk group (p < 0.0004). The diabetes subgroup score was statistically significantly higher compared to the IUGR and the pre-eclampsia subgroup (p = 0.0001). Conclusions: The neurodevelopment fetal assessment by 4D ultrasound appears to be a feasible technique in the evaluation of high risk pregnancies. Further studies where any association between KANET score and neurological outcome of the childhood are warranted.

Keywords::

• 4D ultrasound
• fetal assessment
• fetal neurodevelopment
• high risk pregnancy
• KANET score

Declaration of interest: Dr Apostolos P. Athanasiadis, Dr Themistoklis Mikos, Dr George P. Tambakoudis, Dr Theodoros D. Theodoridis, Dr Maria Papastergiou, and Prof. Efstratios Assimakopoulos, report no declarations of interest. Dr Basil C. Tarlatzis has received unrestricted research grants and Honorarium for activities unrelated to the submitted work from Merck Serono and Merck Sharp & Dohme, as well as travel grants unrelated to the submitted work from Merck Serono, Merck Sharp & Dohme, and IBSA & Ferring.