Early Cranial Ultrasound Findings in Preterm Infants Under 37 Weeks of Gestational Age. Retrospectively Evaluated Experience of a Single Neonatal Intensive Care Unit and Review of the Literature - Abstract
Background: Cranial ultrasound (CUS) is currently recommended between 7 and 14 days of life for infants born before 30 weeks of gestational age (GA). It provides information about possible perinatal brain injury and helps in predicting long-term outcomes. Brain damage occasionally begins already in utero. This retrospective study was designed to evaluate whether early CUS screening is a useful technique providing important information when performed for a broader population of premature infants.
Objective: To evaluate CUS findings in premature infants born before 37 weeks of GA for whom CUS was performed during the first day of life.
Method: A total of 365 premature infants were enrolled in the study. CUS and clinical data were retrospectively collected from the intensive care electronic database.
Results: Day 1 CUS showed pathological findings for 141 infants (38.6%). Intraventricular Hemorrhage (IVH) was demonstrated in 58 infants (15.9% of the total study population). Signs of intraventricular clot liquefaction suggesting in utero IVH were demonstrated in 31 cases out of a total of 58 with IVH (53%). In 14 cases of day 1 CUS showing IVH (24.1%), subsequent CUS was normal. 49 infants (12.6% of total 365) had white matter hyper-echogenic lesions.
Conclusions: An addition to common CUS practices, we propose considering CUS on the first day of life as a means to rule out brain injury which originates in utero, and suggest the use of CUS for a wider population of premature infants born beyond 30 weeks of GA.