Abstract : The capacity of
four-dimensional sonography to evaluate complex
facial expressions allows recognition of a
common behavior, yawning. Although there has
been remarkably little interest in yawning in
research and medical practice, even though it is
an everyday phenomenon, we submit an original
interpretation on the basis of knowledge derived
from phylogeny and ontogeny. As a flip-flop
switch, the reciprocal interactions between
sleep- and wake-promoting brain regions allow
the emergence of distinct states of arousal. By
its ontogenical links with REM sleep, yawning
appears as a behavior which procures an arousal
reinforcement through the powerful stretch and
the neuromuscular rewiring induced. Yawning
indicates a harmonious progress in the
development of both the brainstem and the
peripheral neuromuscular function, testifying to
the induction of an ultradian rhythm of
vigilance. The lack of fetal yawn, frequently
associated with lack of swallowing, associated
or not with retrognathia, may be a key to
predict a brainstem's dysfunction after birth.
(en
français)
Résumé:
L'échographie 4D permet
l'évaluation des expressions faciales du
foetus et en particulier de reconnaître un
comportement banal, le bâillement. Bien
qu'il s'agisse d'un comportement
pluri-quotidien, le bâillement a
suscité peu d'intérêt tant
en recherche qu'en pratique médicale.
Phylogenèse et ontogenèse
permettent de proposer une théorie de son
origine. Comme un interrupteur de type "va et
vient", l'alternance d'action des structures
cérébrales stimulant
l'éveil ou le sommeil engendre
l'émergence de différents
états de vigilance. Succédant
à l'hypotonie musculaire du sommeil
paradoxal avec lequel le bâillement
partage des liens ontogénétiques,
l'étirement musculaire puissant qu'il
représente active par
rétro-contrôle les structures du
tronc cérébral impliquées
dans l'éveil. L'existence du
bâillement chez le foetus témoigne
d'un développement harmonieux du tronc
cérébral, de la fonction
neuro-musculaire périphérique et
de l'installation de rythmes ultradiens de la
vigilance. La reconnaissance de l'absence de
bâillements comme de mouvements de
déglutition, associée ou non
à un rétrognatisme prédit
un risque de dysfonctionnement postnatal du
tronc cérébral. (in
english)
Introduction
The use of ultrasound examinations during
pregnancy allows a type of fetal behavior,
yawning, to be observed on a daily basis. Few
data have been published in the last 25 years on
yawning, thus prompting researchers to state
"yawning is a universally well known, but poorly
understood" [1] and "a rudimentary
reflex, appears to have at best an obscure
purpose, if any" [2]. Although there has
been remarkably little interest in yawning in
research, even though it is an everyday
phenomenon, we will discuss the meaning of this
behavior and how its characterization can
enhance ultrasound investigation. As a foreword,
it should be noted that human research on
prenatal programming of behavior is
intrinsically correlational, never
manipulatively experimental, and frequently
based upon homologies with other
vertebrates.
With significant advances in image quality,
resolution of ultrasound, and now 3D and 4D
technology, the use of ultrasound examination
during pregnancy is a step forward from
anatomical examination to functional evaluation.
Recognition of fetal yawning aids to testify of
the harmonious progress of brainstem maturation
and to understand the neural underpinnings of
sleep and arousal systems. An abnormality yawn's
occurrence fosters an intensive research of
anemic fetuses (frequency amplified) or
brainstem dysfunction with or without mandibular
hypoplasia (frequency sparse or null). We hope
and expect that upcoming researches will
complete the data currently available.
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Abadie
V Développement de la
face : face et
séquence de Pierre Robin
Compte-rendu du 5°
congrès de médecine foetale
2000
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K Kanemshi, et al Real-time 3-D sonographic
observation of fetal facial expression
J Obstet Gynaecol Res 2005; 31;
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A, M Stanojevic et al Behavioral pattern
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