Neurosonographic imaging of small‐for‐gestational‐age neonates exposed and not exposed to cocaine and cytomegalovirus

Dogra, Vikram S.; Menon, Prema; Poblete, Jesse; Smeltzer, James S.

doi:10.1002/jcu.1870220205

Cited by 7 publications

(5 citation statements)

References 35 publications

(7 reference statements)

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“…Pseudocysts may be a marker of chromosomal deletions associated with impaired neuronal migration, such as in Del q6 and Del p4 11,18,19 . Maternal consumption of cocaine has been described as a risk factor 20,21 . However, a prospective longitudinal study 22 compared the neonates of 134 addicted mothers with 132 non-exposed controls and did not show any significant difference in the incidence of ultrasonographic abnormalities (17 vs. 10, P = 0.119) in the two groups at the age of 4 days.…”

Section: Discussionmentioning

confidence: 99%

Subependymal pseudocysts in the fetal brain: prenatal diagnosis of two cases and review of the literature

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et al. 2002

Ultrasound in Obstet & Gyne

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Subependymal pseudocysts are cerebral cysts found in 5% of all neonates. When they are isolated and typical, they result from persistence of the germinal matrix, have a good prognosis and regress spontaneously within a few months. However, associated anomalies are frequent and in such cases the prognosis is poor. They can be of infectious, vascular, metabolic or chromosomal origin. Subependymal pseudocysts have rarely been described in the antenatal period. We report the prenatal diagnosis of two cases of isolated pseudocysts at 32 and 23 weeks. Both ultrasonography and magnetic resonance imaging assisted in the diagnosis and there was normal postnatal outcome in both cases.

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Section: Discussionmentioning

confidence: 99%

Subependymal pseudocysts in the fetal brain: prenatal diagnosis of two cases and review of the literature

Bats

Molho

Sénat

et al. 2002

Ultrasound in Obstet & Gyne

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“…40 -42 Other studies in both species, however, have indicated that prenatal cocaine exposure may be teratogenic in a dose-dependent manner, resulting in abnormalities of the limbs, [43][44][45] cardiovascular, 43,46 genitourinary, 43,44,47,48 and central nervous systems. 43,44,46,47,49 Some human reports have likewise noted anomalies of the genitourinary 3,10,11,13,20,21 and cardiovascular systems, 1,8,14 -16 skull defects, 14 limb defects and intestinal atresias, 6,13,20,21,50 and a variety of central nervous system lesions 4,5,7,9,13,[51][52][53][54][55][56] in infants exposed to cocaine in utero. Two additional studies report mild facial abnormalities in exposed infants.…”

Section: Discussionmentioning

confidence: 99%

The Search for Congenital Malformations in Newborns With Fetal Cocaine Exposure

et al. 2001

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ABSTRACT. Context. The association between prenatal cocaine exposure and congenital anomalies is not definitive.Objective. To determine whether prenatal cocaine exposure results in an increased number or identifiable pattern of abnormalities.Design. A prospective, longitudinal cohort enrolled between 1991 and 1993.Setting. Rural public health population delivering at a regional tertiary medical center.Patients. Two hundred seventy-two offspring of 154 prenatally identified crack/cocaine users and 154 nonusing controls were matched on race, parity, location of prenatal care (that related to level of pregnancy risk), and socioeconomic status. Drug use was determined through repeated in-depth histories and urine screens. Infants not examined within 7 days of birth were excluded.Outcome Measures. Assessments were made by experienced examiners masked to maternal drug history. Included were 16 anthropometric measurements and a checklist of 180 physical features defined and agreed upon in advance.Results. There were no differences on major risk variables between the included and excluded infants. There were significantly more premature infants in the cocaineexposed group. Cocaine-exposed infants were significantly smaller in birth weight, length, and head circumference but did not differ on remaining anthropometric measurements. There was no difference in type or number of abnormalities identified between the exposed and nonexposed groups. There was no relationship between amount or timing of exposure and any of the outcomes.Conclusions. This prospective, large-scale, blinded, systematic evaluation for congenital anomalies in prenatally cocaine-exposed children did not identify an increased number or consistent pattern of abnormalities. A search for congenital malformations related to prenatal cocaine exposure has been underway since physicians became aware of the epidemic of prenatal use in the mid-1980s. Concern has been aroused because of a variety of case reports, small patient series, and retrospective studies reporting abnormalities of the skull, heart, skeleton, gastrointestinal tract, and genitourinary tract in infants born to women who used cocaine during pregnancy. [1][2][3][4][5][6][7][8][9][10][11][12][13] Over the years, the results of prospective studies have yielded somewhat conflicting outcomes. 14 -28 Methodologic concerns in many of these studies have precluded widespread acceptance of their findings, either positive or negative, leaving unanswered the question regarding the association between prenatal cocaine exposure and congenital anomalies.The most commonly identified mechanism of the effects of prenatal exposure involves the vasoconstrictive properties of cocaine. The proper growth and development of the fetus depend on a wellfunctioning vascular system. Vasoconstriction resulting in disruption of blood flow to the fetus could result in the development of structural abnormalities throughout gestation. 29,30 The purpose of this study was to determine whether prenatal cocaine exposure was associat...

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“…1,2,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Basal ganglia hemorrhage results from periventricular hemorrhagic infarction or hemorrhagic necrosis. In preterm infants <28 weeks, diffuse caudate hemorrhage is difficult to differentiate from hemorrhage in the germinal matrix over the body of the caudate nucleus (grade I).…”

Section: Introductionmentioning

confidence: 99%

Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants

et al. 2006

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Objective: To determine the incidence and factors associated with diffuse basal ganglia or thalamus hyperechogenicity (BGTH) in preterm infants.Study Design: (1) Review of serial neurosonograms among neonates with gestational age (GA) <34 weeks born at Weiler Hospital during a 21-month period; (2) Color Doppler flow imaging; (3) Case-control study using GA group-matched controls; and (4) Blind reading of CT scans or MRIs in patients with BGTH.Results: Among 289 infants, 24 (8.3%) had diffuse BGTH. Color Doppler flow imaging was normal in nine patients. The incidence of diffuse BGTH was inversely related to GA (P<0.01). Logistic regression (n ¼ 96) showed that diffuse BGTH was significantly associated with requirement of high-frequency oscillation (HFO) (P ¼ 0.031), severe intraventricular hemorrhage (IVH) (P ¼ 0.004), hypotension requiring vasopressors (P ¼ 0.040), hypoglycemia (P ¼ 0.031) and male gender (P ¼ 0.014). Most patients with diffuse BGTH had normal basal ganglia and thalamus on CT/MRI, one had a hemorrhage, and one had an ischemic infarction.Conclusions: In our series, diffuse BGTH occurred in 8.3%, and was associated with factors similar to those previously reported. In contrast, several series have reported almost exclusively linear or punctuate hyperechoic foci, corresponding to hyperechogenicity of the lenticulostriate vessels. Our data provide further evidence to suggest that diffuse BGTH and hyperechogenicity of the lenticulostriate vessels are two different entities. Additional studies are required to determine the longterm significance of diffuse BGTH.

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Neurosonographic imaging of small‐for‐gestational‐age neonates exposed and not exposed to cocaine and cytomegalovirus

Cited by 7 publications

References 35 publications

Subependymal pseudocysts in the fetal brain: prenatal diagnosis of two cases and review of the literature

Subependymal pseudocysts in the fetal brain: prenatal diagnosis of two cases and review of the literature

The Search for Congenital Malformations in Newborns With Fetal Cocaine Exposure

Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants

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