The Assessment of Fetal Neurobehavior with 4D Ultrasound: the KANET Test

An evolving challenge for obstetrician is to better define normal and abnormal fetal neurological function in utero, in order to better predict antenatally which fetuses are at risk for adverse neurological outcome. Especially the diagnosis of cerebral palsy remains one of the most difficult and challenging clinical situations in obstetrics. The fact that a large number of cerebral damage occurs prenatally and also that early intervention in cases of neurological damage shows better results, in combination with the progression of ultrasound technology, which allows better and real time assessment of the fetus, prompted some researchers to explore the possibility of detecting fetal neurological damage in the uterus. Systematic estimation of a number of parameters from fetal behavior, such as quality of spontaneous fetal movements, cranial sutures, the neurological thumb and a high palate, that were included in the prenatal neurological fetal screening, led to formation of a scoring system for the assessment of fetal neurobehavior, called Kurjak’s antenatal neurodevelopmental test (KANET). The introduction of such a test allows a systematic assessment of fetal neurobehaviour and may distinguish between normal and abnormal behavioral patterns, that could make possible the early recognition of fetal brain impairment.