Estimated Brain Volume at Term Age in Very Preterm Infants with Uncomplicated Grade II And III Intraventricular Haemorrhage

Abstract

Background and aims: In very pre-term new-borns, cerebral lesions are usually complicated with neuro-developmental issues. But un-complicated intra-ventricular haemorrhage (IVH) has no reliable associations with poor outcomes. Objective: In the current work we aimed to assess the impact of un-complicated brain haemorrhage on assessed brain size at term-equivalent ages (TEA), through standard indices made from cranial ultrasound (cUS). Methods: This study included 87 very pre-term babies [< 32 weeks’ gestational age (GA)] up to and at TEA which were divided into two groups; group one included infants with uncomplicated grades II or III IVH, and group two included infants with normal cUS. A previously described standards based on linear measurements were used to calculate the estimated brain volumes at TEA and to compare between the two groups using independent groups t-test; p-value ≤ 0.05 was considered significant. Results: 19 very pre-term babies with un-complicated IVH and 68 with normal images have been studied. Bi-parietal diameter at TEA was shorter in the IVH new-borns (72 vs 87 mm, p-value < 0.05) while thalamo-occipital distance was longer in IVH infants (23.7/21.4 mm, p-value < 0.05)). But, there were non-significant changes at TEA for bi-frontal diameter (69.3 vs 70.1 mm), transverse cerebellar diameter (51.1 vs 49.9 mm), valued cranial size (384/414cc3), valued cerebral size (338/341cc3) and Levene’s ventricular index (1.38/1.23 cm). Conclusions: There is no difference in assessed cerebral size at TEA, built on measures performed at the bedside via cranial US among very pre-term new-borns with dependably ordinary images and those with un-complicated grade II and grade III IVH.