Published 21-09-2021
Keywords
- Preterm Low birth weight,
- Intraventricular hemorrhage,
- Ventricular dilatation
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This work is licensed under a Creative Commons Attribution 4.0 International License.
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Abstract
Introduction: Preterm infants are at high risk of developing brain injury like germinal layer hemorrhage (GLH), intraventricular hemorrhage (IVH), hemorrhagic parenchymal infarction (HPI), cystic periventricular leukomalacia and diffuse non cystic white matter (WM) injury. Cranial ultrasound has been widely used in neonates for early detection of intra-cranial abnormalities which is convenient, non-invasive and safe, without radiation exposure. Early recognition and proper measurement can reduce neonatal mortality and morbidity. Objective: To find out cranial ultra-sonographic features of preterm neonate for proper evaluation and
management of CNS complication. Methodology: This prospective study was carried out from May/13 to Feb/14 in Neonatal Care Unit of Pediatrics department of SSMC & Mitford Hospital. Sixty preterm LBW and VLBW newborns were included by purposive sampling method. All newborns were clinically evaluated at 4th day and at two weeks of life; cranial ultrasonography was done by qualified sinologist. Anterior fontanel was used as acoustic window and thorough examination of brain and ventricles were done in coronal, sagittal and parasagittal plane. Result: Among 60 preterm newborns 35(58%) were LBW and 25(42%) were VLBW. Abnormalities in cranial initial Ultrasonography were found in 4(11.4%) cases at day four in LBW neonate and 9(36%) cases among VLBW neonate. Of them, sub ependymal hemorrhage 1(1.6%) case of LBW, intraventricular hemorrhage 3(5%) cases in VLBW, mild ventricular dilatation 7(11.6%) cases in both groups, moderate and marked dilatation occurred in 1(1.6%) cases and 1(4%) in LBW and VLBW group respectively. After 2 weeks 22(36.33%) newborns had abnormal cranial sonography. Majority 12(20%) had mild ventricular dilatation, followed by moderate and marked dilatation 2(3%) and 3(5%) cases respectively. Sub ependymal hemorrhage in 2(3.3%), Intraventricular hemorrhage was found in 3(5%) cases. Conclusion: This study concluded that Ultrasonography might be an important tool in early diagnosis of ICH in LBW infants which would help in optimum management to reduce mortality and subsequent morbidity.
References
- Halim A, Dewez JE, Biswas A, Rahman F, White S, van den Broek N. When, where, and why are babies dying? Neonatal death surveillance and review in Bangladesh. PloS one. 2016;11(8):e0159388.
- Botting N, Powls A, Cookie RN. Cognitive and educational outcome of VLBW children. Dev. Med. Child Neurol. 1998; 40: 652-660.
- Fukuda S, Kato T, Hussein MH, Suzuki S. Hemodynamics of the cerebral arteries of infants with PVL. Pediatrics. 2006: 117 (1): 1-8.
- Chapman IA, Stoll BJ. Intracranial Intraventricular Hemorrhage and Periventricular Leukomalacia. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. (eds.). Nelson Textbook of Pediatrics. 21st edition. Saunders Elsevier. Philadelphia PA: 715-717.
- Wilkinson I, Bear J, Smith J, Gill A, Challinor C, Jones W, Shahidullah M. et. al. Neurological outcome of severe cystic periventricular leukomalacia. Journal of Paediatrics and child health. 1996;32(5):445-9.
- Trounce JQ, Fagan D, Levene MI. Intraventricular haemorrhage and periventricular leucomalacia: ultrasound and autopsy correlation. Archives of disease in childhood. 1986;61(12):1203-7.
- Richard S. The ventricular System. In: Rob Anthony. Snell’s Clinical Neuroanatomy for Medical Student, 5thed, Lippincott Williams Wilkins. Philadelphia PA.2001: 444-456.
- Chowdhury V, Gulati P, Arora S, Thirupuram S. Cranial Sonography in preterm infants. Indian Pediatrics. 1992; 29: 411-415.
- Volpe JJ. Brain injury in the premature infant: neuropathology, clinical aspects, pathogenesis, and prevention. Clinics in perinatology. 1997;24(3):567-87.
- Boal DK, Watterberg KL, Miles S, Gifford KL. Optimal cost-effective timing of cranial ultrasound screening in low-birthweight infants. Pediatric Radiology. 1995;25(6):425-8.
- Rashid J, Shahid M, Anwar S, Sharaf D, Bhatti T. Frequency of intraventricular haemorrhage in preterm neonates. Pak J Med Health Sci. 2010;4(4):575-78.
- Khodapanahandeh F, Khosravi N, Larijani T. Risk factors for intraventricular Hemorrhage in very low birth weight infants in Tehran, Iran. Turk J Pediatric. 2008; 50:247-52.
- Kadri H, Mawla AA, Kazah J. The Incidence, Timing, and Predisposing Factors of Germinal Matrix and Intraventricular Hemorrhage (GMH/IVH) in Preterm Neonates. Childs Nerv Syst. 2006; 22:1086-90
- Debillon T, N'Guyen S, Muet A, Quere MP, Moussaly F, Roze JC. Limitations of ultrasonography for diagnosing white matter damage in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2003; 88: 275-9.
