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To examine whether artificial intelligence can achieve discoveries regarding fetal brain activity.In this observational study, the authors collected images of fetal faces using a four-dimensional ultrasound technique obtained from singleton pregnancies of outpatients in routine practice at 27 to 37 weeks of gestation between February 1 and December 31, 2021. The authors developed an artificial intelligence classifier to recognize seven facial expressions of fetuses, then applied it to video files of fetal facial images to generate the probabilities, as confidence scores, of each expression category. Discrete Fourier transform and chaotic analysis were used to investigate the scores. Mann-Whitney test, t test, variance test, and one-way analysis of variance were used for statistical analysis.Facial expression changes were observed in cycles averaging 66 to 73 s. The power spectrum showed that mouthing and neutral expressions were the most prevalent. There was a difference between categories for the spectrum (p = 0.004). Two different states--dense and sparse--of confidence scores were discovered. The correlation dimension was 1.19 ± 0.22 and 1.33 ± 0.27 for dense and sparse, respectively (p = 0.047).This method objectively and quantitatively demonstrated fetal brain activity and may provide insight into how the fetus spends its time in utero.

Objectives To study whether the free energy principle can explain fetal brain activity and the existence of fetal consciousness via a chaotic dimension derived using artificial intelligence. Methods In this observational study, we used a four-dimensional ultrasound technique obtained to collect images of fetal faces from pregnancies at 27–37 weeks of gestation, between February and December 2021. We developed an artificial intelligence classifier that recognizes fetal facial expressions, which are thought to relate to fetal brain activity. We then applied the classifier to video files of facial images to generate each expression category’s probabilities. We calculated the chaotic dimensions from the probability lists, and we created and investigated the free energy principle’s mathematical model that was assumed to be linked to the chaotic dimension. We used a Mann–Whitney test, linear regression test, and one-way analysis of variance for statistical analysis. Results The chaotic dimension revealed that the fetus had dense and sparse states of brain activity, which fluctuated at a statistically significant level. The chaotic dimension and free energy were larger in the sparse state than in the dense state. Conclusions The fluctuating free energy suggests consciousness seemed to exist in the fetus after 27 weeks.