Is kurjak antenatal neurodevelopmental test ready for routine clinical application? Bucharest consensus statement

Abstract

Background: While two-dimensional ultrasound (2D US) is used only for the assessment of fetal startles and gene ral movements, introduction of Kurjak antenatal neuro developmental test (KANET) by four-dimensional ultrasound (4D US) enabled assessment of not only movements but also some signs used in postnatal neurological assessment like cranial sutures, head circumference and finger movements of the hand for the detection of neurological thumb (adducted thumb in the clenched feast). Overall impression on general movement called by Prechtl ‘Gestalt perception’ is also a part of KANET assessment. These parameters cannot be assessed by 2D US, and according to our opinion they are making the difference enabling more accurate and functionally more reliable assessment of the young and immature CNS. After Osaka standardization of KANET has been published, many studies on fetal behavior from different centers using this method have been conducted and published. Although there is lack of long-term follow-up of children who were assessed by KANET as fetuses, some conclusions on the usage of KANET test in clinical practice can be made. There are still inconclusive results of prenatal neurological assessment using KANET test in fetuses with borderline scores, although it was revealed that negative predictive value of the test as well as inter-observer reliability were satisfactory and acceptable. Conclusion: It can be concluded that KANET test can be used in everyday clinical practice for the follow-up of fetuses at neurological risk with the strong recommendation for strict and reliable multidisciplinary postnatal follow-up till the corrected age of at least 3 years and longer whenever appropriate. This will enable to make better correlation of prenatal KANET scores with postnatal neurodevelopmental outcomes. © 2015, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved