Fetal behaviour in uncomplicated pregnancies after 41 weeks of gestation. 1994

M van de Pas, and J G Nijhuis, and H W Jongsma
Department of Obstetrics and Gynaecology, University Hospital St-Radboud Nijmegen, The Netherlands.

The development of fetal behaviour and of fetal behavioural states (FBS) has been well defined in preterm and term fetuses. However, FBS have not yet been studied after term, although this is a potentially very dangerous period and clinical management is controversial. We investigated fetal behaviour in normal pregnancies after 41 weeks of gestation (287 days, menstrual age, GA) as compared to control term fetuses. Furthermore, we wanted to see if the findings might have consequences for clinical management. Twelve healthy women with GA between 289 and 298 days participated. All pregnancies were reliably dated and at the time of the study, there was a normal amount of fluid. Twelve healthy women with GA 273-287 days served as controls. All subjects underwent a behavioural study using cardiotocography to record the heart rate (CTG), and two ultrasound scanners to observe body and eye movements, as described previously. All fetuses in both groups clearly exhibited FBS 1F-4F which fitted the definitions of Nijhuis et al. The median percentage of FBS 3F and 4F ('awake states') increased significantly from 6% in the term group to 21.5% in the fetuses after 41 weeks (P = 0.014). FBS 1F ('quiet sleep') and 2F ('active sleep') decreased from 92 to 78% (P = 0.014), mainly at the expense of FBS 2F which decreased from 78 to 58% (P = 0.002). This indicates increasing wakefulness in utero. The fetal heart rate patterns (FHRP) associated with FBS 3F and 4F were impressive. For example, in FBS 4F, the FHRP showed large amplitude, prolonged accelerations which fused into a sustained tachycardia with only short periods of return to the baseline, resembling tachycardia with decelerations. We conclude that in normal pregnancies after 41 weeks, the development of the fetal central nervous system continues, resulting in an increasing percentage of 'fetal wakefulness'. The CTG-patterns that result from these behaviours can easily mimic fetal distress and one should be aware of this phenomenon. Whether behavioural studies can be used to distinguish 'normal' from 'abnormal' fetuses after term awaits further study.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005133 Eye Movements Voluntary or reflex-controlled movements of the eye. Eye Movement,Movement, Eye,Movements, Eye
D005260 Female Females
D005324 Fetal Movement Physical activity of the FETUS in utero. Gross or fine fetal body movement can be monitored by the mother, PALPATION, or ULTRASONOGRAPHY. Fetal Activity,Fetal Activities,Fetal Movements
D005333 Fetus The unborn young of a viviparous mammal, in the postembryonic period, after the major structures have been outlined. In humans, the unborn young from the end of the eighth week after CONCEPTION until BIRTH, as distinguished from the earlier EMBRYO, MAMMALIAN. Fetal Structures,Fetal Tissue,Fetuses,Mummified Fetus,Retained Fetus,Fetal Structure,Fetal Tissues,Fetus, Mummified,Fetus, Retained,Structure, Fetal,Structures, Fetal,Tissue, Fetal,Tissues, Fetal
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006340 Heart Rate, Fetal The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute. Fetal Heart Rate,Fetal Heart Rates,Heart Rates, Fetal,Rate, Fetal Heart,Rates, Fetal Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001519 Behavior The observable response of a man or animal to a situation. Acceptance Process,Acceptance Processes,Behaviors,Process, Acceptance,Processes, Acceptance

Related Publications

M van de Pas, and J G Nijhuis, and H W Jongsma
January 2008, Gynecologic and obstetric investigation,
M van de Pas, and J G Nijhuis, and H W Jongsma
March 2015, Journal of perinatal medicine,
M van de Pas, and J G Nijhuis, and H W Jongsma
January 2020, Fetal diagnosis and therapy,
M van de Pas, and J G Nijhuis, and H W Jongsma
January 2016, Japanese clinical medicine,
M van de Pas, and J G Nijhuis, and H W Jongsma
May 1998, Early human development,
M van de Pas, and J G Nijhuis, and H W Jongsma
January 2012, Fetal diagnosis and therapy,
M van de Pas, and J G Nijhuis, and H W Jongsma
June 2020, American journal of obstetrics and gynecology,
M van de Pas, and J G Nijhuis, and H W Jongsma
May 2003, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit,
M van de Pas, and J G Nijhuis, and H W Jongsma
February 2004, Twin research : the official journal of the International Society for Twin Studies,
M van de Pas, and J G Nijhuis, and H W Jongsma
October 1997, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics,
Copied contents to your clipboard!