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• W2007886012 abstract "For (patho)physiological and diagnostic reasons it would be helpful to be able to quantify human fetal swallowing movements, as has been suggested previously1, 2. We performed a literature search via PubMed on this topic (searching until 2005) and found that no-one except Petrikovsky et al.3 has ever quantified human fetal swallowing movements. Various other studies have quantified ovine fetal swallowing4, 5. With this in mind and using definitions adapted from those of Miller et al.6, we performed a prospective observational study to assess the possibility of quantification of human fetal swallowing by ultrasound, including B-mode color flow and B/M-mode flow measurements. From January to May 2005 we investigated 16 consecutive fetuses with normal anatomy and a normal amount of amniotic fluid. Every fetus was examined once, distributed evenly over two gestational age periods: 20–23 and 34–37 weeks (two per week). The fetal profile was visualized for a period of 30–60 min (14 min in one case). When the visualization allowed, we used B- and B/M-mode flow analyses. Every 5–10 min, fetal eye movements were recorded for 5–10 s. The video recordings of our examinations were analyzed subsequently. The duration for which the profile was visualized with or without forelying limbs or fetal head movements, and the amount and duration of swallowing bouts and other mouth movements were recorded. These parameters were related to the fetal state as assessed by the eye movements (rapid eye movement (REM), non-REM or non-classifiable). The fetal profile was, on average, visualized sufficiently to quantify fetal swallowing and other movements of the fetal mouth for only 33% of the examination time. This was mainly because of fetal movements and obstruction of the view by forelying limbs (Figure 1). Mouthing movements were recognizable and quantifiable in 81% of the fetuses. These movements are characterized by a burst of quickly repeating, waving movements of the tongue and a quickly changing in- and outward flow, seen with B-mode color flow, apparently without a net in- or outflux of amniotic fluid. Fetal swallowing movements were very difficult to recognize and count because of simultaneous head movements. In 62% of the fetuses (partial) swallowing movements were seen incidentally. Swallowing movements coincided with REM periods, in particular in the fetuses nearly at term, while mouthing movements coincided with non-REM periods. The use of B-mode color flow and B/M-mode flow measurements contributed very little in quantifying mouth movements, and especially swallowing, because of simultaneous color coding of the tongue and coinciding head movements, respectively. Classification of individual examination times in 16 fetuses: time fetal profile visualized without fetal movements and forelying limbs (), time fetal profile visualized, but with forelying limbs () or with fetal head movements (), and time profile not visualized (□). Case numbers consist of the gestational age (GA) in weeks, followed by 1 or 2, representing the first or second fetus examined at this age. The results of this study show that reliable quantification of human fetal swallowing activity by ultrasound is not achievable, even when B-mode color flow and B/M-mode flow measurements are used. The fetal profile is visible for too little time, and when it is visible, fetal swallowing nearly always coincides with head movements that make a good appraisal and quantification impossible. In our opinion, other authors could study fetal swallowing movements in such detail only because they searched for quality, not quantity. Other ways in which to quantify human fetal swallowing activity need to be found. A. van den Brink*, Ph. Stoutenbeek*, * University Medical Center Utrecht, Department of Obstetrics and Gynaecology, Utrecht, The Netherlands" @default.
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• W2007886012 date "2006-11-09" @default.
• W2007886012 modified "2023-09-23" @default.
• W2007886012 title "Quantification of fetal swallowing by ultrasound is impossible" @default.
• W2007886012 cites W2020525413 @default.
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• W2007886012 doi "https://doi.org/10.1002/uog.3851" @default.
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