CAN BRAIN IMPAIRMENT BE DETECTED BY IN-UTERO BEHAVIORAL-PATTERNS

Fetal behavioural patterns were examined to test whether they could be used to localise sites of brain damage antenatally. Decreased fetal m ovement, persistent non-reactive fetal heart rate (FHR) pattern, and/o r central nervous system malformation were used as indicators of possi ble neurological impairment. Ten fetuses tested in this way underwent further ultrasound examination observing movement of the extremities, chest wall (breathing), and eye and mouth, and active/quiet FHR patter ns. Eight of these 10 fetuses were found on postnatal examination to h ave a brain impairment. The fetuses having potential in utero brain im pairment were divided into four groups: those with (1) lesion sites at , or caudal to, the pons-medulla that were specifically identified by fetal behaviour, (2) diffuse lesions in the brain which, although resu lting in abnormal behaviour, could not be localised by this behaviour, (3) lesions localised in the cerebral hemisphere(s) but with no abnor mal behaviour, and (4) temporally abnormal behaviour in utero, finally changing over to a normal pattern with no neonatal neurological abnor mality. A screening system for the antenatal assessment of brain impai rment is thus proposed.