Minimal facial movements of the fetus as one of the diagnostic criteria intrauterine distress

Abstract

The use of the facial movements' evaluation of the fetus as an additional criterion for the detection of the possible fetal distress development is one of the promising trends in modern neonatology, since fetuses from 20-22 to 28 weeks of gestation are a vulnerable group for the development of distress conditions due to the impossibility of using cardiotocography among them.

The aim of the study is to assess the conditions of distress in fetuses in the period from 22-24 weeks of gestation using a standardized set of facial expressions of newborn children in ultrasound diagnostics in 3D and 4D resolution.

Material and methods. The study included 313 fetuses in the gestation period of at least 22-24 weeks, which were consulted and ultrasound-diagnosed in Voronezh Regional Clinical Hospital No.1 "Perinatal Center" in the period of 2017-2019. All the fetuses were divided into 2 groups: the 1st group - fetuses with diagnosed cases of distress in obstetric history (n=98), and the 2nd group - fetuses with no clinical signs of distress (n=215). The main criteria for the inclusion of fetuses in the 1st group of the study were the presence of one or more signs: tachycardia/bradycardia; persistent monotonous of rhythm (recording of 5 bpm or less); early, variable and late deceleration with amplitude of more than 30 beats/min. All fetuses with clinical signs of distress mentioned above were examined immediately after CTG by GE Healthcare Voluson 730.

Results and discussions. During the study, special attention was given to the consistent sets of facial movements of the fetus, where important diagnostic (and subsequent predictive feature) traits were lowering eyebrows, raising inner part of the eyebrow, raising outer part of the eyebrow, and converging inner corners of the eyebrows. This sequence at the time of distress was evaluated by us as a fundamental combination of actions on the face of the fetus.

Conclusions. The comparative data obtained show that the "reading of emotions" is promising in the early diagnosis of "fetal distress". Evaluation of the facial movements of the fetus, which allows to detect the fetal distress needs to be examined and popularized further, since it does not include any additional material costs and can be used in a vulnerable group of fetuses (unacceptable CTG method) from 20-22 to 28 weeks of gestation.

Keywords:neonatology, premature infants, fetal distress, facial movements, ultrasound diagnosis

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Korotaeva N.V., Ippolitova L.I., Fedotova T.V., Chibisova N.A., Pershina E.S. Minimal facial movements of the fetus as one of the diagnostic criteria intrauterine distress. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2020; 8 (2): 7-12. DOI: 10.33029/2308-2402-2020-8-2-7-12 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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