About
25 years ago, we were first to apply the Pediatric practice of identifying
milestones of development in childhood to the fetal world (American Journal
of Roentgenology, 1978). If you know when an infant should smile, roll
over,
sit-up walk, and so you, you have a way to determine if functional development
is on time or delayed. A few years later we were first in showing
that
rapid eye movements (indicating a sleep state associated with dreaming) occur in fetal life
and can be measured and characterized. We pay particular attention to automatic
functions like breathing and eye movements, swallowing and mouth movements as a clue to brain development and function. In many ways, fetuses act as if they are anesthetized, which may be protective under the oxygen poor conditions within the womb. When oxygen levels decline even further, autonomic and other movements are suppressed to conserve energy. Movement pattrerns provide the best clues to fetal wellness and distress. |
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3D viewing has been a advance in our ability to assess motor behavior, because it lets us look at movements in separate regions at the same time, like combined hand and face motor activity. The pattern of motor development, typically, is to make a movement and then, days or weeks later to be able to inhibit that movement. Control and coordination arise from balance between action and counteraction. We pay special attention to expressions as an indicator of fetal condition.. Behavioral "competence" changes throughout pregnancy. It is important to reference ultrasonic, fetal behavioral studies to the gestational age at the time of the exam. Behavioral "states" such as alertness, deep sleep and active sleep, obvious in newborns, start to emerge by the mid third trimester when mothers become aware of the activity cycles. |
