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Pediatrics15 papers

Neonatal hypokinesia

Last edited: 4/16/2026

Overview

Neonatal hypokinesia, often described under the term "Pena Shokeir phenotype," refers to a constellation of clinical features resulting from reduced fetal movement in utero, characterized by polyhydramnios, intrauterine growth retardation, pulmonary hypoplasia, craniofacial and limb anomalies, congenital contractures, and often lethality 1.

Diagnosis

  • Key Diagnostic Criteria: Polyhydramnios, intrauterine growth retardation, pulmonary hypoplasia, craniofacial anomalies, limb anomalies, congenital contractures 1.
  • Recommended Tests: Detailed prenatal ultrasound to identify cardinal signs; postnatal physical examination for confirmation 1.
  • Grading: No specific grading system universally accepted; diagnosis based on clinical presentation and exclusion of other causes 1.

    • Management

  • First-Line Treatments: Supportive care including respiratory support for pulmonary hypoplasia, management of feeding difficulties, and physical therapy for contractures 1.
  • Adjunctive Treatments: Multidisciplinary approach involving neonatologists, orthopedic surgeons, and geneticists for comprehensive care 1.
  • Specific Drug Classes/Doses: Not specified in current evidence; treatment tailored to individual anomalies 1.

    • Special Populations

  • Pregnancy: Recognition of polyhydramnios and intrauterine growth retardation can alert clinicians to potential fetal akinesia/hypokinesia sequence 1.
  • Pediatrics: Focus on palliative care and symptomatic management postnatally, with emphasis on developmental support 1.

    • Key Recommendations

  • Use "Pena Shokeir phenotype" or "fetal akinesia/hypokinesia sequence" to avoid implying a single diagnostic entity (Evidence: Expert opinion) 1.
  • Early recognition of any cardinal sign should prompt thorough evaluation for associated anomalies (Evidence: Expert opinion) 1.
  • Implement a multidisciplinary approach for comprehensive management of neonates presenting with this phenotype (Evidence: Expert opinion) 1.

    • References

    1 Hall JG. Analysis of Pena Shokeir phenotype. American journal of medical genetics 1986. link

    Original source

    1. [1]
      Analysis of Pena Shokeir phenotype. — Hall JG American journal of medical genetics (1986)
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