English

Abstract

Neonatal care in India is advancing at an impressive phase at the level of the community as well as in tertiary care units. Concept of of newborn has given way to intact survival of the high risk newborn emphasizing detection of neurological subnormalities at the earliest. Neurosonography, which is now ubiquitously available, is an ideal tool for the primary screening of the neonatal brain. Despite its wide availability in the hospitals, the penetration of cranial ultrasonography in Indian NICU's is still very little. OBJECTIVE: This study was undertaken to assess the importance of cranial ultrasound as an investigatory modality for high risk neonates and to find out the morphology of various cerebral lesions and correlate clinically. METHODS: This observational clinical study was conducted at Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bangalore between January 2013 and January 2014. 100 high risk neonates admitted to our NICU were included in the study. Detailed history and clinical examination with appropriate investigations were done. These neonates were subjected to neurosonography on selected days as per protocol and morphology of various findings was recorded. Clinical correlation with CUS findings and follow up was done. RESULTS: Incidence of CUS abnormalities in high risk neonates is 24% in the present study. 11% of these had evidence of intracranial bleed, 7% hyperechogenic thalami, 2% definite HIE, and 4% had cerebral edema. Of the 24% of neonates with abnormal findings on CUS 23.5% had no evidence of perinatal asphyxia, 28.6% had severe, 30% had moderate 33.3% had mild perinatal asphyxia as per Apgar scoring. Two neonates on regular follow up CUS had developed cystic encephalomalacia with hydrocephalus. CONCLUSION: This study highlights the convenience and diagnostic efficiency of cranial ultrasound in high risk neonates in NICU. It also emphasizes its use as a screening modality for preterms and birth asphyxia neonates influencing their neurodevelopmental outcome. CUS is critical as an investigatory modality in NICU