Early Detection of Central Nervous System Abnormalities by Neurosonography in Critically Ill Neonates

Document Type : Original Article

Authors

Department of Pediatrics, Jawaharlal Nehru medical college, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha- 442004, Maharashtra, India

Abstract

Background: Neurosonography has been widely used for screening and early detection of Central Nervous System (CNS) defects, such as intraventricular hemorrhage, hydrocephalus, cerebral edema, or any structural anomalies in the neonatal brain in the neonatal intensive care unit (NICU) of a tertiary level hospital. The present study aimed to assess the detection of CNS abnormalities by neurosonography in critically ill neonates.
Methods: This prospective cross-sectional study at the Neonatology Unit of the Paediatric Department of Acharya Vinoba Bhave Rural Hospital (AVBRH). A neonate was described as “critically ill” based on detailed maternal history and clinical examination. These neonates were subjected to neurosonography according to the inclusion and exclusion criteria in accordance with the noted protocols and various anomalies. Gestational age, birth weight, clinical examination, investigation, neurosonography finding, and outcomes were evaluated.
Results: Neurosonography was performed in 105 critically ill neonates, out of whom 21 cases had abnormal neurosonography findings. Abnormal neurosonography was not significantly correlated with birth weight and gestational age of high-risk neonates (P=0.538 &P=0.130). The most frequent clinical manifestation was respiratory distress syndrome, followed by a neonatal seizure. The mean scores of heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and oxygen saturation were obtained at 140±19.81, 54.08±13.07, 90.96±8.66, 54.13±8.39, and 94.39±6.93, respectively.
Conclusion: Neurosonography is a useful tool in NICU. It is an acceptable and reliable modality to screen critically ill neonates, assisting the early detection and management of these ill neonates.
 

Keywords

References

  1. Nagaraj N, Berwal PK, Srinivas A, Sehra R, Swami S, Jeevaji P, et al. A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit. J Pediatr Neurosci. 2016; 11(3):200-5.
  2. Kinikar U, Dhanawade S. Study of cranial ultrasound its correlation with perinatal risk factors and its outcome in preterm neonates admitted to Neonatal intensive care unit. Int J Pediatr Res. 2018; 5(4):169-74.
  3. Gahlot A, Joshi A. Role of neurosonography in neonates with clinically suspected intracranial pathology. Int J Res Med Sci. 2019; 7(6):2302.
  4. Pape KE, Bennett-Britton S, Szymonowicz W, Martin DJ, Fitz CR, Becker L. Diagnostic accuracy of neonatal brain imaging: A postmortem correlation of computed tomography and ultrasound scans. J Pediatr. 1983; 102(2):275-80.
  5. Stark JE, Seibert JJ. Cerebral artery Doppler ultrasonography for prediction of outcome after perinatal asphyxia. J Ultrasound Med. 1994; 13(8):595-600.
  6. Bracci R, Perrone SN. Hypoxic-ischemic encephalopathy: clinical aspects. In: Volpe J, editor. Neurology of the newborn. 5th Philadelphia, PA: WB Saunders; 2001. P. 218-80.
  7. de Vries LS, Groenendaal F. Neuroimaging in preterm infants. Ment Retard Dev Disabil Res Rev. 2002; 8(4):273-80.
  8. Daneman A, Epelman M, Blaser S, Jarrin JR. Imaging of the brain in full-term neonates: does sonography still play a role? Pediatr Radiol. 2006; 36(7):636-46.
  9. Van Wezel-Meijler G. Cranial ultrasonography: advantages and aims. Neonatal cranial ultrasonography. 1st Berlin: Springer; 2007. P. 3-4.
  10. Mercuri E, Dubowitz L, Brown SP, Cowan F. Incidence of cranial ultrasound abnormalities in apparently well neonates on a postnatal ward: correlation with antenatal and perinatal factors and neurological status. Arch Dis Child Fetal Neonatal Ed. 1998; 79(3):F185-9.
  11. Badrawy N, Edrees A, Sebaie DE, El-Ghawas M. Cranial ultrasonographic screening of the preterm newborn. Alex J Pediatr. 2005; 19(2):347-56.
  12. De Vries LS, Wigglesworth JS, Regev R, Dubowitz LM. Evolution of periventricular leukomalacia during the neonatal period and infancy: correlation of imaging and postmortem findings. Early Hum Dev. 1988; 17(2-3):205-19.
  13. Fumagalli M, Ramenghi LA, De Carli A, Bassi L, Farè P, Dessimone F, et al. Cranial ultrasound findings in late preterm infants and correlation with perinatal risk factors. Ital J Pediatr. 2015; 41:65.
  14. Vermeulen GM, Bruinse HW, Gerards LJ, de Vries LS. Perinatal risk factors for cranial ultrasound abnormalities in neonates born after spontaneous labour before 34 weeks. Eur J Obstet Gynecol Reprod Biol. 2001; 94(2):290-5.
  15. Glass HC, Bonifacio SL, Sullivan J, Rogers E, Ferriero DM, Goldstein R, et al. Magnetic resonance imaging and ultrasound injury in preterm infants with seizures. J Child Neurol. 2009; 24(9):1105-11.
  16. van Houten JP, Rothman A, Bejar R. High incidence of cranial ultrasound abnormalities in full-term infants with congenital heart disease. Am J Perinatol. 1996; 13(1):47-53.
  17. Levene MI. Measurement of the growth of the lateral ventricles in preterm infants with real time ultrasound. Arch Dis Child. 1981; 56(12):900-4.
  18. Ghoor A, Scher G, Ballot DE. Prevalence of and risk factors for cranial ultrasound abnormalities in very-low-birth-weight infants at Charlotte Maxeke Johannesburg Academic Hospital. South Afr J Child Health. 2017; 11(2):66-70.
  19. Ballabh P. Pathogenesis and prevention of intraventricular hemorrhage. Clin Perinatol. 2014; 41(1):47-67.
  20. Mulindwa MJ, Sinyangwe S, Chomba E. The prevalence of intraventricular hemorrhage and associated risk factors in preterm neonates in the neonatal intensive care unit at the University teaching hospital, Lusaka,Med J Zambia. 2012; 39(1):16-21.



 

Iranian Journal of Neonatology
Volume 12, Issue 4
October 2021
Pages 15-21

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