Impaired in vivo feto-placental development is associated with neonatal neurobehavioral outcomes.

BACKGROUND: Fetal growth restriction (FGR) is a risk factor for neurodevelopmental problems, yet remains poorly understood. We sought to examine the relationship between intrauterine development and neonatal neurobehavior in pregnancies diagnosed with antenatal FGR. METHODS: We recruited women with singleton pregnancies diagnosed with FGR and measured placental and fetal brain volumes using MRI. NICU Network Neurobehavioral Scale (NNNS) assessments were performed at term equivalent age. Associations between intrauterine volumes and neurobehavioral outcomes were assessed using generalized estimating equation models. RESULTS: We enrolled 44 women diagnosed with FGR who underwent fetal MRI and 28 infants underwent NNNS assessments. Placental volumes were associated with increased self-regulation and decreased excitability; total brain, brainstem, cortical and subcortical gray matter (SCGM) volumes were positively associated with higher self-regulation; SCGM also was positively associated with higher quality of movement; increasing cerebellar volumes were positively associated with attention, decreased lethargy, non-optimal reflexes and need for special handling; brainstem volumes also were associated with decreased lethargy and non-optimal reflexes; cerebral and cortical white matter volumes were positively associated with hypotonicity. CONCLUSION: Disrupted intrauterine growth in pregnancies complicated by antenatally diagnosed FGR is associated with altered neonatal neurobehavior. Further work to determine long-term neurodevelopmental impacts is warranted. IMPACT: Fetal growth restriction is a risk factor for adverse neurodevelopment, but remains difficult to accurately identify. Intrauterine brain volumes are associated with infant neurobehavior. The antenatal diagnosis of fetal growth restriction is a risk factor for abnormal infant neurobehavior.

Using ultrasound to teach living anatomy to non-medical graduate students.

PURPOSE: Ultrasound technology is used to supplement gross anatomy instruction in many medical sciences programs. However, this technology is not common practice for anatomy instruction in nonmedical graduate-level courses. Ultrasound sessions provide a clear view of local anatomy and could help graduate students transfer anatomical content from a didactic context onto a living, moving body. This approach to instruction complements the rapidly evolving technological advances in science education and may assist with spatial understanding, knowledge retention, and student engagement. The main objective of this article was to describe the methods used to incorporate ultrasound sessions into a graduate level gross anatomy course. METHODS: The goal of the curricula was to use ultrasound technology to create a supplemental hands-on and engaging method of learning anatomy that would appeal to graduate students and possibly reinforce content. Graduate students participated in three interactive, 2-h-long ultrasound sessions that corresponded to their gross anatomy lecture material. RESULTS: Questionnaire results showed that students overwhelmingly believed that the ultrasound sessions were beneficial and that ultrasound technology should be used for anatomical instruction in graduate programs. While students found the sessions to be helpful, they sought more and longer sessions with smaller group sizes. CONCLUSION: Overall, this article describes the methods used to incorporate multimodal learning into a graduate level anatomy course and found that students supported the methods as a potentially effective and engaging way to supplement traditional gross anatomy lectures and practical laboratory sessions.