Foetal mouth movements: Effects of nicotine.

AIM: To assess whether foetal mouth movement frequency changes across gestation and whether there are differences between cigarette and e-cigarette exposure conditions in comparison to a non-exposed group of foetuses. METHOD: Pregnant women underwent 4-dimensional (4D) foetal ultrasound scans at 32 weeks (106 scans) and 36 weeks of gestational age (87 scans) at James Cook University Hospital, UK. The 4D scans were coded using the Fetal Observable Movement System (FOMS). Measures of maternal smoking status, stress, depression, anxiety, attachment and time of scan were also collected. There were four exposure groups: non-smokers, light smokers (<10 per day), heavy smokers (11-20 per day) and e-cigarette users. RESULTS: No significant differences in relative frequency of mouth movements between the exposure groups at 32- and 36 weeks of gestational age were found. Foetal mouth movements declined from 32 to 36 weeks of gestation for non-exposed and e-cigarette-exposed foetuses. CONCLUSION: Due to variability in foetal behaviour, examining mouth movements alone may not be the most appropriate method for assessing group differences. However, in line with other research, mouth movement frequency declined between 32- and 36 weeks of gestational age. A combination of foetal behavioural assessments is needed to assess the effects of cigarette and e-cigarette exposure on foetal neurobehavioural development.

Ultrasound observations of subtle movements: a pilot study comparing foetuses of smoking and nonsmoking mothers.

AIM: One way to assess foetal health of smokers is to ask mothers to count perceived movements, an unreliable method hiding differences in prenatal development. The aim of this pilot study was to assess subtle foetal movements in ultrasound scans and establish whether they differ in foetuses of mothers who smoked and nonsmoking mothers. METHODS: This longitudinal pilot study recruited twenty mothers (16 nonsmoking; 4 smoking) scanned four times from 24 to 36 weeks gestation (80 ultrasound scans). Two types of fine-grained movements were coded offline and analysed using a Poisson log-linear mixed model. RESULTS: Foetuses of smoking mothers showed a significantly higher rate of mouth movements compared to foetuses of nonsmoking mothers (p = 0.02), after controlling for maternal stress and depression. As pregnancy progressed, these differences between the smoking and nonsmoking groups widened. Differences between the two groups in the rate of foetal facial self-touch remained constant as pregnancy progressed and were borderline significant (p = 0.07). CONCLUSION: Rates of foetal mouth movement and facial self-touch differ significantly between smokers and nonsmokers. A larger study is needed to confirm these results and to investigate specific effects, including the interaction of maternal stress and smoking. Additionally, the feasibility of this technique for clinical practice should be assessed.

Pregnancy in dystonic women with in situ deep brain stimulators.

In the past few years, an increasing number of dystonic patients, of both sexes, have undergone insertion of deep brain stimulators (DBS) with consistent improvement of their symptoms and enhancement of their quality of life. We describe 3 women with dystonia who, after insertion of bilateral globus pallidus internus stimulators, succeeded in conceiving and completing pregnancies, 2 of them having married. These histories illustrate the significant positive impact that DBS can have on women's social relationships. Based on this experience, we also provide an overview of some of the issues that might arise in pregnancy and during delivery in dystonic women with an in situ deep brain stimulator.