A STUDY ON CLINICO-EPIDEMIOLOGICAL PROFILE AND CORRELATION BETWEEN CRANIAL ULTRASONOGRAPHY FINDINGS AND SEVERITY OF HYPOXIC ISCHAEMIC ENCEPHALOPATHY IN TERM NEONATES WITH PERINATAL ASPHYXIA ADMITTED AT SNCU IN A RURAL MEDICAL COLLEGE AND HOSPITAL IN WEST BENGAL, INDIA

Abstract

Introduction: Perinatal asphyxia (PNA) is dened as failure to initiate and sustain breathing after birth. PNA leading to Hypoxic ischemic encephalopathy (HIE) is a dreaded neurological condition of the newborn. HIE is one of the important causes of neonatal morbidityBackground: and mortality in the rst week of life. Neuroimaging plays an essential role in the assessment of brain injury in HIE patients. 1.To studyObjectives: the clinico-epidemiological prole of term neonates with PNA 2.To study the serial cranial USG ndings in asphyxiated term neonates in rst week of life. 3. To assess the correlation between concurrent use of serial cranial ultrasonography ndings in term neonates with PNA and with regards to the severity of HIE. This hospital based cross-sectional study was conducted at SNCU of Bankura Smmilani MedicalMaterials And Methods: College and Hospital, Bankura. 100 cases of term neonates with HIE admitted at SNCU from 1st December 2021 to 31st January 2022 were taken as study population. All the relevant history was taken based on clinico-epidemiological parameters and detailed clinical- examination was done. Serial cranial USG was perfomed in rst week of life. In our study among 100 neonates, 62 (62%) cases belonged to HIE-I, 29 (29%) casesResult: with HIE-II, and 9(9%) cases with HIE-III. 42(42%) cases showed normal Cranial USG nding, 24(24%) cases showed cerebral oedema, 14 (14%) cases showed Gr-I IVH, 10(10%) cases showed Gr-II IVH, 6(6%) cases showed Gr-III IVH and 4(4%) cases showed Gr-IV IVH. Among HIE-I neonates, 42(67.7%) cases had normal cranial USG ndings and 20(32.2%) cases showed cerebral oedema. In HIE-II neonates, 4(13.7%) cases showed cerebral oedema, 14(48.2%) cases showed Gr-I IVH, 10(34.4%) cases showed Gr-II IVH and 1(3.44%) case showed Gr-III IVH. In neonates with HIE-III, 5 (55.5%) cases showed Gr-III IVH and 4 (44.4%) cases showed Gr-IV IVH. Correlation of cranial USG shows worsening trend with increasing severity of HIE as per Sarnat and Sarnat staging. Chi-square test revealed strong positive correlation. (p= 0.0001, rs=0.9) Conclusion: This study concluded that the serial cranial USG ndings in PNA neonates when done in rst week of life, revealed a strong positive correlation with the severity of HIE. Cranial USG is cost effective, easily available and is ideal for the initial assessment of neonates with HIE.