Study of cranial ultrasound its correlation with perinatal risk factors and its outcome in preterm neonates admitted to Neonatal intensive care unit

Abstract

Aims and Objectives:To determine the frequency of cranial ultrasound abnormalities in preterm neonates in the first week of life. To evaluate the association between cranial ultrasound findings and perinatal risk factors in regard to the immediate clinical outcome. Materials and Methods: This Retrospective study was done in NICU in a tertiary hospital. Records of all preterm neonates (<37weeks) admitted to NICU who underwent neuro-sonography between Jan2016 -Jan 2017 were included. Results: Out of 100 preterms, 53% had normal CUS findings while 47% had abnormal finding. Abnormal CUS was significantly associated with gestational age <32weeks (p<0.001) and birth weight <1.5kg (p=0.006). Among the abnormal CUS findings intraventricular hemorrhage was the most common (40.42%) followed by periventricular hyper-echogenicity (21.27%), cystic periventricular leukomalacia (8.51%), parenchymal bleed (8.51%), cysts (8.51%), cerebral edema (6.38%), ventriculomegaly (4.25%) and thalamic injury (2.12%). Neonatal comorbidities associated with abnormal cranial ultrasound were RDS (25.53%), neonatal sepsis (21.27%), birth asphyxia (17.02%), neonatal seizures (8.51%), NEC (6.38%) and others (21.27%). There was significant association between abnormal cranial ultrasound and RDS (p=0.014) and birth asphyxia (p=0.008). Mortality was 36.1% and all had abnormal cranial USG. Intraventricular hemorrhage (76.4%) was the most common cause of death followed by parenchymal bleed (11.7%). Conclusion: There was significant association between abnormal CUS and gestational age and birth weight. Most common abnormality was IVH and it carried the highest mortality. RDS and birth asphyxia had significant association with abnormal ultrasound. Early neurosonography could help in prognosticating immediate outcome and early intervention.

Faktor-Faktor Risiko Kejadian Lesi Serebral pada Bayi Prematur

“…Dalam penelitian lain yang dilakukan oleh Kinikar dkk, 3 insidensi kejadian kelainan serebral mencapai 47%, sementara dalam penelitian Bradway dkk, 5 insidensinya adalah 32%.4,5 Hasil penelitian Kinikar dkk juga melaporkan bahwa insidensi perdarahan intraventrikular meningkat pada bayi dengan usia gestasi kurang dari 32 minggu dan berat lahir di bawah 1500 gram. Sementara dalam penelitian Bradway dkk, 5 insidensi perdarahan intraventrikular meningkat pada usia kehamilan kurang dari 30 minggu.…”

“…Lebih dari itu, USG kepala juga berfungsi sebagai alat pemantauan perkembangan otak, dengan tujuan mencegah terjadinya sekuele pada sistem saraf pusat, yakni otak. 3 Penelitian ini dilaksanakan untuk melihat kejadian lesi serebral pada bayi prematur di Rumah Sakit Umum Pusat (RSUP) Dr. Kariadi serta melihat faktor risiko yang ada pada bayi prematur dengan lesi serebral pada bayi prematur yang di rawat di ruang perinatologi RSUP Dr. Kariadi Semarang.…”

Performance of the correlation relationships of structural changes in the brain during pneumonia in infants

“…Особо опасна пневмония у младенцев первых трех месяцев жизни: последствия этого процесса часто приводят к его гибели [12][13][14]. Больничная летальность в РФ снизилась до 0,6%, однако у 70% детей до одного года причиной смерти в стационаре стала именно пневмония, причем досуточная летальность при ней составила 40%, и этот показатель, к сожалению, не снижается [4,5,15]. Прогноз неонатальной пневмонии зависит от пренатального анамнеза, течения родов и раннего неонатального периода.…”

Role of Neurosonography in Critically Ill Neonates in NICU

“…In neonates, fontanels and the many other suture lines remain unfused and act as a window for visualizing the inner brain maturation and pathological abnormalities. [1][2][3] Neurosonography plays an important role in critically ill neonates for regularly assessing the neonatal brain. It can identify most of the ischemic, hemorrhagic, cystic, and infective brain lesions and other severe structural abnormalities.…”

“…It is also useful in the timely detection of the causative factors of seizures and neonatal encephalopathy and then be used for sequential monitoring of hypoxic-ischemic brain damages. [2][3][4] In critically ill neonates with hypoxic-ischemic encephalopathy (HIE) and congenital or acquired brain anomalies, NUSG helps in assessing the gravity of neurodevelopment and its outcomes. [3][4][5][6] After birth, an NUSG can be used for screening of neonatal brain if clinically indicated.…”