CORRELATION OF MRI BRAINS WITH NEUROLOGICAL OUTCOME AT 12 MONTHS OF AGE IN NEWBORNS WITH HYPOXIC ISCHAEMIC ENCEPHALPATHY AT A TERTIARY REFERRAL HOSPITAL OF KOLKATA: A PROSPECTIVE LONGITUDINAL STUDY

Abstract

Introduction:In spite of an improved understanding of its pathogenesis , perinatal asphyxia and resulting hypoxic ischemic encephalopathy (HIE) is one of the most dreaded neurological disease of the newborn. Published data show that 25-60% of the babies who survive, suffer from permanent neuro developmental handicaps including cerebral palsy, seizures, mental retardation, and learning disabilities. Aims & Objectives: To correlate Magnetic Resonance Imaging (MRI) Brain with neurological outcome at 12 months in term (more than or equal to 37 weeks gestational age) neonates with Hypoxic Ischemic Encephalopathy. Materials And Methods: Sick Newborn Care Unit (SNCU) and Neonatal Intensive Care Unit (NICU) of R G Kar Medical College & Hospital, Kolkata(2) Department of Radiology of R.G.Kar Medical College & Hospital, Kolkata. From February 1st, 2019 to July 31st 2020. Aprospective observational study in longitudinal design. Results:All the babies with fetal bradycardia(N=19) had abnormal cardiotocographical ndings, out of them 16 babies had suspicious suspicious ndings and 3 had pathological cardiotocographical ndings. Most of the cases with abnormal CTS (N=19) i.e. Suspicious(N1=16)+ Pathological(N2=3) were delivered by LSCS(18) followed by breech vaginal (1). About 45.5 % of the study population had MSL (meconium stained liquor), followed by clear liquor(27.3%), blood stained (21.21%). Only 6.1% showed features of chorioamionitis with foul smelling liquor. Summary & Conclusion:Though normal MRI babies can later be normal or may have minor disabilities in future. But MRIs showing moderate to severe grade of injuries always resulted in severe neuromotor disabilities like cerebral palsies. Further large population studies in other regions of India are to be conducted to emphasize the role of a validated MRI Scoring system to determine the possible clinical outcomes. This will help to initiate early interventions and thus can improve outcomes.