Feasibility of prenatal hearing test.

Variability in foetal responses to sound stimulations is described and the effect of the different factors involved in this reactivity, in particular the physical characteristics of the stimulus and state of alertness of the foetus, is discussed. Results obtained with a high pass filtered pink noise at a 106, 109 and 113 dB SPL on 37-40 week foetuses are given to illustrate this dependency. For all tested levels, responsiveness was reduced after repetition of the stimulus. This was observed even at 113 dB when stimulation was preceded by a series of lower level stimuli to which foetuses were (or became) unresponsive. Motor responses (lower limb movements) were the first and the most affected by stimulus repetition, followed by cardiac response decrement--but with a lower proportion of non-responses, especially at 113 dB. Consequently, with this specific stimulus, cardiac reactivity seems a more reliable parameter to examine when more than one stimulus is needed to ascertain foetal hearing. It was also demonstrated that foetuses were much less reactive when stimulated during low heart rate variability sequences than during high heart rate variability. Testing of prenatal hearing seems feasible in utero and should be a promising method for detecting gross hearing impairment once the influence of each biophysical parameter has been carefully studied.