Role of transcranial Doppler in assessment of cerebral blood flow in full term neonates with extreme unconjugated hyperbilirubinemia

Abstract

Purpose To evaluate the difference in cerebral blood flow in neonates with and without extreme unconjugated hyperbilirubinemia. Methods Transcranial Doppler parameters of 26 full term newborns with extreme unconjugated hyperbilirubinemia (UCH) were compared to 13 postnatal age and sex matched normal healthy neonates serving as controls. Resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV) were measured in the middle cerebral, internal carotid and posterior cerebral arteries on both sides by transcranial color Doppler ultrasound. Results An increase in cerebral blood flow (decreased RI, PI and increased PSV) was observed in the extreme unconjugated hyperbilirubinemia (UCH) group. There was positive correlation between total serum bilirubin level and peak systolic velocity and vice versa with resistivity and pulsatility indices. Eight neonates developed clinical features of acute bilirubin encephalopathy and showed significantly increased peak systolic velocity in the right middle cerebral artery compared to those with normal outcome. Resistivity index and pulsatility index were lower in patients managed by exchange transfusion compared to those managed with phototherapy. Conclusion An increase in cerebral blood flow was observed in neonates with UCH compared to those without hyperbilirubinemia. By assessing the cerebral blood flow velocity, resistivity index (RI), and pulsatility index (PI) of particular intracranial arteries, the transcranial Doppler can identify the at-risk neonates, for development of neurological affliction in extreme unconjugated hyperbilirubinemia.

Effects of information-knowledge-attitude-practice health education combined with cluster-based care in patients with gestational hypertension

“…Studies have shown that IKAP health education model can improve patients' pregnancy outcomes and newborn health conditions. [28] In this study, patients with pregnancy-induced hypertension were chosen as the study objects to analyze the application effect of IKAP health education combined with cluster-based The For example, pregnancy index greatly outperformed the CG's, indicating that IKAP health education combined with cluster-based care had more obvious control effect. Prenatal anxiety levels showed statistically significant variations (P < 0.05).…”

“…Studies have shown that IKAP health education model can improve patients’ pregnancy outcomes and newborn health conditions. [ 28 ]…”