Cranial Ultrasound in Moderate and Late Preterm Neonates: A Prospective Observational Study

  • Om Krishna Pathak Department of Paediatrics, Bharatpur Hospital, Ministry of health, Government of Nepal, Nepal
  • Yengkhom Rameshwor Singh Department of Paediatrics, JN Institute of Medical Sciences, Imphal, Manipur, India
  • Rahul Mugurkar Department of Paediatrics, Amrut Balrugnalaya, Auranganad, India
  • Pradeep Suryawanshi Department of Neonatology, Bharati Vidyapeeth Deemed University Hospital, India
Keywords: Cranial ultrasound, late preterm, moderate preterm

Abstract

Introduction: Preterm infants’ brain is vulnerable to ischemic and hemorrhagic injuries due to structural and molecular immaturities as well as associated co-morbidities, which is usually detected by bedside cranial ultrasound. Cranial ultrasound findings are common in preterm infants’ of < 32 weeks, so cranial ultrasound is routinely recommended in them but there is no such recommendation regarding moderate and late preterm infants. The objective of this study is to find the cranial ultrasound abnormalities in moderate and late preterm infants.

Methods: This prospective observational study was conducted in a tertiary level neonatal care unit. Hundred moderate and late preterm neonates delivered or admitted within seventh day of life were included in the study. Cranial ultrasound scan was performed between third and seventh day of life and before discharge and ultrasound findings were noted. Data were collected in predesigned case record form and analysed using Fischer Exact test.

Results: Out of 100 neonates, 47 (47%) were males and 53 (53%) females. There were 43 (43%) moderately preterm and 57 (57%) late preterm infants. Mean day of life for performing first and second cranial ultrasound was 4.17 (3 - 7) days and 13.24 (3 - 40) days respectively. Cranial abnormalities were noted in 26% neonates. Intra-ventricular haemorrhage grade 1 or 2 was the commonest abnormality noted. Choroid plexus cyst (4%), cerebral edema (3%), periventricular hyperechogenicity (3%) and hydrocephalus (1%) were the other abnormalities noted. Neonates having APGAR < 6 at one minute, mechanically ventilated and having co-morbidities had significantly higher incidence of abnormal findings.

Conclusions: It is reasonable to perform screening cranial ultrasound in high risk moderate and late preterm infants having low APGAR score, mechanically ventilated and having co-morbidities.

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Author Biographies

Om Krishna Pathak, Department of Paediatrics, Bharatpur Hospital, Ministry of health, Government of Nepal, Nepal

Department of Pediatrics

Consultant Pediatrician

Neonatologist and Pediatric Intensivist

Yengkhom Rameshwor Singh, Department of Paediatrics, JN Institute of Medical Sciences, Imphal, Manipur, India

associate professor, department of pediatrics

Rahul Mugurkar, Department of Paediatrics, Amrut Balrugnalaya, Auranganad, India

consultant neonatologist

Pradeep Suryawanshi, Department of Neonatology, Bharati Vidyapeeth Deemed University Hospital, India

Consultant Neonatologist and Head of department, Department of Neonatology

Published
2021-04-24
How to Cite
Pathak, O., Singh, Y., Mugurkar, R., & Suryawanshi, P. (2021). Cranial Ultrasound in Moderate and Late Preterm Neonates: A Prospective Observational Study. Journal of Nepal Paediatric Society, 41(1), 42-47. https://doi.org/10.3126/jnps.v41i1.31024
Section
Original Articles