Fetal neurological development and prenatal detection of fetal and infant neurological pathologies, such as cerebral palsy, is a major challenge in perinatal medicine. The development of 4D ultrasound has not only enabled better visualization of fetal anatomy, but also the study of fetal behavior in real time.
To this end, the KANET (Kurjak Antenatal Neurodevelopment Test) was developed, which uses 4D ultrasound to assess fetal neurological development and behavior in the same manner as the postnatal examination of the newborn. For this purpose, KANET has been used for 15 years and is a powerful diagnostic tool in daily practice. The test is preferably performed between 28-38 weeks in the 3rd trimester and takes 15-20 minutes.
The criteria and applications for this are as follows.
- Isolated forward movement of the head
- Cranial sutures and head circumference
- Eye movements
- Changes in the face (wrinkling and tongue protrusion)
- Mouth movements (yawning, opening of the mouth)
- Isolated hand gestures
- Isolated foot movements
- Movements of the hands towards the face
- Finger movements
- Complex movements and their continuity
According to these criteria, 4D observations are scored between 0 and 2 (0-5: abnormal, 6-13: borderline, 14-20: normal). In case of negative results, pregnancy monitoring is continued at 2-week intervals, while in case of normal results, a decision is made to continue monitoring.
Resource:
- Talic A, Kurjak A, Ahmed B, Stanojevic M, Predojevic M, Kadic AS, Di Renzo GC. The potential of 4D sonography in the assessment of fetal behavior in high-risk pregnancies. J Matern Fetal Neonatal Med. 2011; 24: 948-954.
- Kurjak A, Antsaklis P, Stanojevic M, Vladareanu R, Vladareanu S, Neto RM, Barisic LS, Porovic S, Delic T. Multicentric studies of the fetal neurobehavior by KANET test. J Perinat Med. 2017; 45: 717-727.
- Hata T, Kanenishi K, Mori N, AboEllail MAM, Hanaoka U, Koyano K, Kato I, Kusaka T. Prediction of postnatal developmental disabilities using the antenatal fetal neurodevelopmental test: KANET assessment. J Perinat Med. 2018; 47: 77-81.
- Kurjak A, Spalldi Barišić L, Stanojević M, Antsaklis P, Panchal S, Honemeyer U, Moreira Neto R, Tinjić S, Vladareanu R, Esin S, Bomba-Opon D, Međedović E, Hata T. Multi-center results on the clinical use of KANET. J Perinat Med. 2019; 47: 897-909