Department of Obstetrics and Gynaecology, Research Institute MOVE, VU University Medical Centre, Amsterdam, The Netherlands.
Early Hum Dev. 2010 Feb;86(2):107-11. doi: 10.1016/j.earlhumdev.2010.01.026. Epub 2010 Feb 25.
General movements (GMs) assessed three months post term are related to brain injury and neurological outcome.
To study GMs in fetuses and their predictive value for echogenicity changes in the fetal brain.
Prospective study of fetal GMs (classified as normal or abnormal) and echogenicity changes in the periventricular, basal ganglia/thalami area, and ventricular system (classified as absent, mild or moderate).
121 fetuses from pregnancies affected by hypertensive disorders and/or preterm labour, at risk for preterm birth (26-34weeks gestational age).
Prevalence of abnormal GMs, GM parameters (amplitude, speed and complexity), and moderate echogenicity changes in the fetal brain (periventricular >or=IB, intraventricular grade II/III, and basal ganglia/thalamus locally increased). Predictive values of GMs for clinical parameters and moderate echogenicity changes.
GMs were abnormal in 58%, with amplitude affected in 96%, and speed and complexity in 59%. Abnormal GMs correlated with oligohydramnios (p=0.002) and hypertensive disorders (p=0.015). Echogenicity changes of the brain were absent, mild and moderate in 27%, 39% and 31%, respectively. The sensitivity of GMs for moderate echogenicity changes in the three areas combined was 0.65, and the periventricular area 0.85, specificity both 0.44, negative predictive values 0.73 and 0.96 respectively.
Qualitative abnormal GMs are frequent in fetuses of compromised pregnancies, and correlate with hypertensive disorders and oligohydramnios. The amplitude of GMs was most frequently affected. Abnormal GMs relate to moderate echogenicity changes especially in the periventricular area of the fetal brain, while normal GMs predict absence of moderate echogenicity changes.
足月后三个月评估的一般性运动（GMs）与脑损伤和神经结局有关。
研究胎儿 GMs 及其对胎儿脑回声变化的预测价值。
前瞻性研究胎儿 GMs（分为正常或异常）和脑室周围、基底节/丘脑区和脑室系统的回声变化（分为无、轻度或中度）。
121 例受高血压疾病和/或早产影响的胎儿，有早产风险（26-34 周胎龄）。
异常 GMs 的发生率、GM 参数（振幅、速度和复杂性）以及胎儿脑中度回声变化（脑室周围>或=IB、脑室分级 II/III 和基底节/丘脑局部增强）。GMs 对临床参数和中度回声变化的预测值。
GMs 异常率为 58%，振幅受影响率为 96%，速度和复杂性受影响率为 59%。异常 GMs 与羊水过少（p=0.002）和高血压疾病（p=0.015）相关。脑回声变化无、轻度和中度分别为 27%、39%和 31%。GMs 对三个区域联合中度回声变化的敏感性为 0.65，脑室周围区域为 0.85，特异性均为 0.44，阴性预测值分别为 0.73 和 0.96。
处于高危妊娠胎儿中 GM 定性异常较为常见，与高血压疾病和羊水过少相关。GMs 的振幅最常受影响。异常 GMs 与中度回声变化有关，特别是胎儿脑的脑室周围区，而正常 GMs 则预测无中度回声变化。
