Intracranial ultrasonographic screening of premature babies meeting the criteria

Abstract

Background: The preterm infant brain is most vulnerable to both haemorrhagic and ischemic injury during the late second and early third trimesters. This is due to vascular, cellular, and anatomical features of the developing brain and the tendency of preterm infants to experience periods physiological instability at a time when they have limited cerebral circulatory auto regulation. CUS is useful for recording PVH, PVL, measurement of resistive index and ventricular dilatation. The study was to determine the magnitude of abnormal intracranial findings among the preterm neonates admitted in NICU of S.S. Institute of Medical Science and Research Centre, Davangere by using cranial ultrasonography.Methods: The study was intended to do CUS in pre-terms with gestation age of less than 32 weeks or those with birth weight of less than 1500 grams irrespective of gestational age and Preterm with abnormal neurological presentation. Infants enrolled were divided in to groups according to gestational age, birth weight and results analysed by using Epi info version 6 software, p value <0.05 is considered significant.Results: Most common abnormalities found is intra ventricular haemorrhage (7.8%), ventricular dilatation (1%), agenesis of corpus callosum (1%). There is significant correlation between birth weight and gestational age (p value <0.05) and prevalence of intra ventricular haemorrhage in <28 weeks (group 1) is more (15. 4%), compared to group 2 (28-32weeks), and group 3 (>32 weeks).Conclusions: The prevalence of Intra ventricular haemorrhage is significantly higher as the gestational age decreases. Neonatologist can take ethical decisions depending on intracranial abnormalities as it changes line of management. CUS helps in directing the families of affected infants towards most appropriate follow up and to promote early intervention for chronic neurodevelopmental sequelae of haemorrhagic or ischemic injury. So, all neonatologist working in NICU should be trained in CUS.