Assessment of the fetus: relevance to brain injury.

This article reviews recent advances in the antepartum and intrapartum assessment of the fetus and their relationship to brain injury in the newborn. The antepartum assessment involves observation of fetal body and eye movements, the nonstress and contraction stress tests, measurement of amniotic fluid volume, the fetal biophysical score and measurement of fetoplacental blood physiology. There is evidence to suggest that seizures may either be epileptic in origin or initiated and mediated by nonepileptic mechanisms. Therapeutic decisions may be based on bedside assessment of the pathophysiology of observed seizures. Although EEG/video monitoring plays a role in the management of neonatal seizures, clinical evaluation of the seizures may provide initial data critical to decisions concerning immediate management.