MODERN METHODS OF FETAL ANTENATAL DIAGNOSTICS AND THEIR SIGNIFICANCE FOR THE SUBSEQUENT CHILD DEVELOPMENT

The fetal neurobehaviour helps to evaluate the integrativity of the brain function. The distinctive signs of the fetal motor patterns allow us to diagnose developmental disorders at early stages.

The purpose is to review literature related to the study of the integrative activity of the central nervous system, the development and use of modern methods of fetal neuropsychological ultrasound diagnostics - the antenatal test of neurodevelopment after A. Kurjak (Kurjak Antenatal Neurodevelopmental Test - KANET).

The results and conclusion. Using ultrasound of pregnant women at different gestation periods helps us to directly observe and evaluate fetal movements reflecting activity of the maturing central nervous system. The KANET test based on the observation of the fetal motor pattern according to the Prechtl’s method allows us to evaluate the fetal motor activity and predict development and functioning of the central nervous system after birth. The fetal antenatal neuropsychological diagnostics is used for timely detection of the disorders of central nervous system and early implementation of preventive and curative measures for the consequences of CNS damage: neurological, emotional and behavioral disorders in older children.

1. Prechtl H.F.R., Nolte R. Motor behaviour of preterm infants. In: Prechtl H.F.R. (Ed.) Continuity of neural functions from prenatal to postnatal life. Blackwell Scientific Publications Ltd, Oxford, England. Clin Develop Med 1984; 94: 79–92.

2. Prechtl H.F.R., Fargel J.W., Weinmann H.M., Bakker H.H. Postures, motility and respiration of low-risk preterm infants. Developmental Medicine & Child Neurology 1979; 21: 3–27.

3. Prechtl H. Qualitative changes of spontaneous movements in fetus and preterm infants are the marker of neurological dysfuction. Early Human Development 1990; 23: 151–159.

4. Brigandt I. Gestalt experiments and inductive observations: Konrad Lorenz’s early epistemological writings and the methods of classical ethology. Evolution and Cognition 2003; 9: 157–170.

5. Lorenz K. The role of Gestalt perception in animal and human behavior. In: Whyte L.L. (Ed.) Aspects of form: a symposium on form in nature and art. Lund Humphries: London, 1951; 157–178.

6. Lorenz K. Gestalt Perception as Fundamental to Scientific Knowledge. General Systems 1962; 7: 37–56.

7. Almli C. R., Ball R. H., Wheeler M. E. Human fetal and neonatal movement patterns: gender differences and fetal-toneonatal continuity. Dev Psychobiol 2001; 38(4): 252–273.

8. Einspieler C., Prechtl H.F., Ferrari F., Cioni G., Bos A.F. The qualitative assessment of general movements in preterm, term and young infants–review of the methodology. Early Hum Dev 1997; 50(1): 47–60.

9. Cazalets J.R., Squalli-Houssaini Y., Clarac F. Activation of the central pattern generators for locomotion by serotonin and excitatory amino acids in neonatal rat. J Physiol 1992; 455: 187–204.

10. Feller M.B. Spontaneous correlated activity in developing neural circuits. Neuron 1999; 22: 653–656.

11. de Vries J.I.P., Visser G.H.A., Prechtl H.F.R. The emergence of fetal behaviour. 1. Qualitative• aspects. Early Hum Develop 1982; 7: 301–322.

12. de Vries J.I.P., Visser G.H.A., Prechtl H.F.R. The emergence of fetal behaviour. II. Quantitative aspects. Early Hum Develop 1985; 12: 99–120.

13. de Vries J.I.P., Fong B.F. Normal fetal motility: an overview. Ultrasound Obstet Gynecol 2006; 27: 701–711.

14. Einspieler C., Prechtl H. Prechtl’s assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Mental retardation and developmental disabilities research review 2005; 11: 61–67.

15. Roodenburg P.J., Wladimiroff J.W., van Es A., Prechtl H.F.R. Classification and quantitative aspects of fetal movements during the second half of pregnancy. Early Hum Dev 1991; 25: 19–35.

16. Kurjak A., Kupesic S., Banovic L., Hafher T., Kos M. The study of morphology and circulation of early embryo by threedimensional ultrasound and Power Doppler. J Perinat Med 1999; 27: 145.

17. Kurjak A., Tikvica A., Stanojevic M., Miskovic B., Ahmed B., Azumendi G., Di Renzo G.C. The assessment of fetal neurobehavior by three-dimensional and four-dimensional ultrasound. J Matern Fetal Neonatal Med 2008; 21(10): 675–684. DOI: 10.1080/14767050802212166

18. Kurjak A., Andonotopo W., Stanojevic M., Milenkovic D., Azumendi G., Hafner T., Ujevic B. Longitudinal study of fetal behavior by four-dimensional sonography. The Ultrasound Review of Obstetrics and Gynecology 2005; 5(4): 259–274.

19. Blair E., Stanley F.J. Intrapanum asphyxia: a rare cause of cerebral palsy. J Pediatr 1988; 112(4): 515–519.

20. Reddihough D.S., Collins K.J. The epidemiology and causes of cerebral palsy. Austral J Physiotherapy 2003; 49: 7–12.

21. Visser G.H.A., Laurini R.N., de Vries J.I.P., Bekedam D.J., Prechtl H.F.R. Abnormal motor behaviour in anencephalic fetuses. Early Hum Develop 1985; 12: 173–182.

22. Hadders-Algra M. General movements: a window for early identification of children at high risk for developmental disorders. J Pediatr 2004; 145: 12–18.

23. Tomasovic S., Predojevic M. 4D Ultrasound – Medical Devices for Recent Advances on the Etiology of Cerebral Palsy. Acta Inform Med 2011; 19(4): 228–234. DOI: 10.5455/aim.2011.19.228–234

24. Hadders-Algra M. Putative neural substrate of normal and abnormal general movements. Neuroscience and Biobehavioral Reviews 2007; 31: 1181–1190.

25. Harrison P.J. The neuropathology of schizophrenia. A critical review of the data and their interpretation. Brain 1999; 122(4)593–624.

26. Honemeyer U., Talic A., Therwat A., Paulose L., Patidar R. The clinical value of KANET in studying fetal neurobehavior in normal and at-risk pregnancies. J Perinat Med 2013; 41(2):187–197. DOI: 10.1515/jpm-2011-0251

27. Grillner S., Deliagina T., Ekeberg O.E., Manira A., Hill R.H., Lansner A., Orlovsky G.N., Wallen P. Neural networks that coordinate locomotion and body orientation in lamprey. Trends Neurosci 1995; 18: 270–279.

28. O’Donovan M.J. The origin of spontaneous activity in developing networks of the vertebrate nervous system. Curr Opin Neurobiol 1999; 9: 94–104.

29. Hadders-Algra M. The Neuronal Group Selection Theory: a framework to explain variation in normal motor development. Develop Med Child Neurol 2000; 42: 566–572.

30. Edelman G.M. Neural Darwinism: The Theory of Neuronal Group Selection. Basic Books, New York 1987; 371.

31. Sporns O., Tononi G., Edelman G.M. Theoretical neuroanatomy and the connectivity of the cerebral cortex. Behav Brain Res 2002; 135: 69–74.

32. Chen Y., Seth A.K., Gally J.A., Edelman G.M. The power of human brain magnetoencephalographic signals can be modulated up or down by changes in an attentive visual task. Proc Natl Acad Sci USA 2003; 100: 3501–3506.

33. Edelman G.M. Naturalizing consciousness: A theoretical framework. Proc Natl Acad Sci USA, 2003; 100: 5520–5524.

34. Izranov V.A., Kazantseva N.V. Evaluation of antenatal neurodevelopment of the fetus during screening ultrasound. Ultrasound and functional diagnostics: Abstracts of the VII Congress of specialists in ultrasound diagnostics of Siberia (April 20–22, 2016, Barnaul) 2016; 2: 96–97. (in Russ)

35. Kazantseva N.V., Izranov V.A. Diagnostic and prognostic meaning of the evaluation of fetal behavior in ultrasound research. Ultrasonic and functional diagnostics: Abstracts of the VII Congress of specialists of ultrasound diagnostics in Siberia (April 20-22, 2016, Barnaul) 2016; 2: 97–98. (in Russ)

36. Kazantseva N.V., Izranov V.A. Fetal behavior and the prediction of neuropsychiatric development. Bulletin of the Immanuel Kant Baltic Federal University. Series “Natural and Medical Sciences” 2016; 2: 39–50 (in Russ) URL: https://journals.kantiana.ru/vestnik/3233/9041/

37. Izranov V.A., Martinovich M.V., Kazantseva N.V. KANET: application in ultrasonography and challenges of protocoling. Bulletin of the Immanuel Kant Baltic Federal University. Series “Natural and Medical Sciences” 2016; 4: 5–16 (in Russ) URL: https://journals.kantiana.ru/vestnik/3400/9584/

38. Shotik Yu.V., Shevtsova O.A. Modern assessment methods of fetus general movements. Smolensk Medical Almanac 2017; 1: 382–385. (in Russ) URL: https://cyberleninka.ru/journal/n/smolenskiy-meditsinskiy-almanah#/983519.

39. Volpe J.J. Brain injury in the premature infant: current concept and prevention. Biol Neonate 1992; 62: 231–242.

40. Wu W.Y., Croen L.A., Shah S.J., Newman T.B., Najjar D.V. Cerebral Palsy in a Term Population: Risk Factors and Neuroimaging Findings. Pediatrics 2006; 118:690–697.

41. Surveillance of cerebral palsy in Europe (SCPE). Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol 2002; 44:633–640.

42. Batysheva T.T., Krapivkin A.I., Tsaregorodtsev A.D., Sukhorukov V.S., Tikhonov S.V. Rehabilitation of children with the pathology of central nervous system. Ros Vestn Perinatol i Pediatr 2017; 62(6): 7–15 DOI: 10.21508/1027–4065–2017–62–6–7–15 (in Russ).