Understanding the pattern of maturation of the fetal brain sets the stage for ultrasonographic documentation of neural development or damage. General movements and primary reflexes are the expression of spinal motor activity in the first half of pregnancy, but increasingly complex functions denote the switch over from initial spinal control to a higher control in the second half of the pregnancy. Both the Prechtl Neurologic Assessment and the Amiel-Tison Neurologic Assessment at Term have been used as the basis for proposed three- and four-dimensional ultrasonographic criteria of central nervous system optimality and fetal central nervous system compromise. The predictive value of such imaging is limited by its “hands-off” observation and the immaturity of the fetal brain, but the possibility of employing such advanced imaging holds great promise.

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