Role of Neurosonography in the Evaluation of Neonatal Hypoxic Brain Injury

Abstract

Introduction: Incomplete formation and maturation of the nervous system in preterm neonates makes them highly susceptible to CNS injury causing neurodevelopmental disabilities ranging from mild learning disabilities, gross motor delays to cerebral palsy and mental retardation.

Methodology: The present study is a non-interventional, prospective, cross-sectional observational study conducted over a period of 1.5 years at the Department of Radiodiagnosis, A.C.S Medical college and Hospital, Chennai. A total 60 preterm neonates who were admitted to neonatal intensive care unit (NICU) were selected as per the inclusion criteria on a non-randomized purposive sampling basis and were subjected to neurosonography on selected days.

Results: Out of 60 preterm neonates included in the study, 28 (46.7%) patients are female and 32(53.3%) are male. Out of 60 preterm neonates included in the study, 17 (28.3%) patients have a gestational age of 34-36weeks and a least number of neonates, 13 (21.7%) neonates have a gestational age of 28-30 weeks. In the study there was significant association between Abruptio placenta, IUGR, Preeclampsia with ICH. Among subjects with Abruptio Placenta 75% had ICH, among subjects with IUGR, 80% had ICH and among subjects with Preeclampsia, 72.7% had ICH.

Conclusion: Hypoxic-ischemic injury of the brain in preterm neonates is a devastating condition with significant morbidity and mortality. HIE and intracranial hemorrhage are two ends of the spectrum of hypoxic-ischemic events. Though MRI is considered as a gold standard, despite the limitations of the present study, neurosonography has reported high sensitivity and specificity in detection of hypoxic brain injury in preterm neonates.