FETAL SEIZURES

Fetal movement in utero is a direct expression of neural activity and a good test of fetal central nervous system dysfunction (1). Because the central nervous system continues to grow postnatally, there is a continuum of neural function from prenatal to postnatal life (1). It is therefore expected than neural dysfunction in the fetus would be similar to those found in the neonate. Normal fetal movement - Well coordinated generalized fetal movements.

Movement in neural malformations are disorganized, ranging from rapid myoclonic jerking of the fetal extremities to slow subtle, repetitive, rhythmic motions of the shoulders and both upper and lower extremities (varying frequency and intervals between the abnormal movements) (2).

ETIOLOGY

• Idiopathic.
• Associated with genetic syndromes (fetal akinesia sequence) (2).

ULTRASOUND

• Characteristic fetal movement which may be either:
• Repetitive and episodic, consistent with seizures.
• Regularity of the movements at a frequency consistent with seizures.
• Fetal akinesia.
• Abnormal position of the fetal fingers (some flexed and some extended) (3).
• Abnormal limb and head extension (3).
• Growth retardation (4).
• ± Demonstrable central nervous system abnormality (5).

REFERENCES

1. Prechtl HF. Fetal behaviour. Eur J Obstet Gynecol Reprod Biol 1989;32:32.
2. Skupski DW, Sepulveda W, Udom-Rice I et.al. Fetal seizures: Further observations. Obstet Gynecol 1996;88:663-665.
3. Abrams LA, Balducci J. Fetal seizures: A case study. Obstet Gynecol 1996;88:661-663.
4. Shimizu T, Nagai T, Nishimura R et.al. Does fetal seizure activity mean a poor outcome? A case report. J Reprod Med 1991;36:453-454.
5. Conover WB, Yarwood RL, Peacock MD et.al. Antenatal diagnosis of fetal seizure activity with use of real time ultrasound. Am J Obstet Gynecol 1986;155:846-847.