Cranial Ultrasonographic Findings in Preterm Infants at Tanta Neonatal Intensive Care Unit (NICU)

Abstract
Background: Premature neonates are at risk for brain injury both hemorrhagic and ischemic injury. Intracranial hemorrhage is the most common abnormal cranial finding followed by PVL and hydrocephalus. Considering that most of the brain lesions are clinically silent during the neonatal period, routine cranial ultrasonography screening may be needed to detect a variety of brain lesions in the preterm infants.
Aim: The aim was to detect cranial ultrasonographic findings in preterm infants for initiation of appropriate, protective and therapeutic measures.
Methods and Material: This study was carried out on all preterms infants that were admitted in the NICU of Pediatric Department at Tanta University Hospital during the study period over one year using cranial US in the first 3 days of life and on 7th, 14th and 21 st days of life and after any clinical intercurrent events through anterior, posterior and mastoid fontanelle with a single operator, who was unaware of any clinical data of the studied preterms.
Results: Most of the preterms were asymptomatic and hypotonia was the main symptom among symptomatic pre-terms. ICH was the most common abnormal CUS finding followed by PVL and hydrocephalus. Hydrocephalus was the main complication of ICH cases. Regarding the grading of ICH, grade III represented the predominant grade. In the studied preterms, those with gestational age £32 weeks, birth weight <_1.5 Kg, Hb £10gm.dL, and mean PCO2 >45 were more likely to have abnormal findings on cranial US exam-ination.
Conclusions: Cranial US may be recommended as a routine examination in every preterm infant as most of preterms with abnormal cranial US findings are asymptomatic. The incidence of abnormal CUS findings increases with decreasing gestational age, birth weight, APGAR score, Hb, pH and HCO3 and with increasing HR, RR, CRP, mean PCO2 and length of stay.