Absent Fetal Movement Response with a Blunted Cardioacceleratory Fetal Response to External Vibratory Acoustic Stimulation in a Fetus with the Pena-Shokeir Syndrome (Fetal Akinesia and Hypokinesia Sequence)

We present a case that describes a partial fetal response to external vibratory acoustic stimulation in that, although no fetal movements were elicited, a blunted, brief positive cardioacceleratory response was noted. This fetus exhibited features of the Pena-Shokeir syndrome, characterized by skeletal neurogenic atrophy, yet with a normal auditory system at autopsy. This observation may suggest that the prolonged increase in the basal fetal heart noted after fetal vibratory acoustic stimulation is sustained by active fetal movements, absent in this fetus due to joint contractures.