Assessment of Hypoxic Ischemic Changes in Perinatal Asphyxia of First Ultasonogram of Brain

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Abstract

Background: In in perinatal asphyxia, hypoxic ischemic brain injury remains most serious condition causing significant mortality and long term morbidity. Early detection of intracranial changes and its consequences will enhance timely intervention and better out come. Cranial sonography can be done to assess the abnormalities of brain in perinatal asphyxia. Objectives: The objective of this study was to evaluate usefulness of assessment of Hypoxic Ischemic Changes in perinatal asphyxia of first Ultasonogram of Brain. Methods: This was an observational study conducted from March 2018 to February 2019 at department of radiology and imaging, Dhaka Shishu Children Hospital, Dhaka, Bangladesh. Total 100 neonates with perinatal asphyxia were included in this study. Cranial USG was done in all cases and sonographic abnormalities were evaluated. Result: This study was 56 term (>37 weeks of gestation) and 44 preterm (<37 weeks of gestation) newborn having birth asphyxia were taken as cases in this study. Common cranial sonographic findings of preterm babies were periventricular leukomalacia 29% (13), germinal matrix hemorrhage 14% (6), Intraventricular hemorrhage 11% (5) cerebral oedema 7% (3) and normal 39% (17). Common cranial USG findings in term babies were cerebral oedema 43% (24), intracerebral hemorrhage 5% (3), Focal cerebral infarct 4% (2), Intraventricular hemorrhage 2% (1) and normal 46% (26). Conclusion: This study found that transcranial sonography is useful to identify the abnormalities in brain of asphyxiated neonate and helps to predict the neurodevelopmental outcome. So proper management plan can be done.
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围生儿窒息时脑首次超声缺氧缺血性改变的评价
背景:在围产期窒息中,缺氧缺血性脑损伤是最严重的疾病,可导致严重的死亡率和长期发病率。早期发现颅内病变及其后果,有助于及时干预,提高预后。颅脑超声检查可用于评估围产儿窒息时脑的异常。目的:本研究的目的是评价首次脑超音波对围生儿窒息缺氧缺血性改变的评估价值。方法:这是一项观察性研究,于2018年3月至2019年2月在孟加拉国达卡Shishu儿童医院放射与影像科进行。本研究共纳入100例围产期窒息新生儿。所有病例均行颅骨超声心动图检查,并对超声异常进行评估。结果:本研究以56例足月(>37孕周)新生儿和44例早产(<37孕周)新生儿的出生窒息为例。早产儿常见的颅超声表现为脑室周围白质软化29%(13例),生发基质出血14%(6例),脑室内出血11%(5例),脑水肿7%(3例),正常39%(17例)。足月婴儿颅骨USG常见表现为脑水肿43%(24例),脑出血5%(3例),局灶性脑梗死4%(2例),脑室内出血2%(1例),正常46%(26例)。结论:本研究发现经颅超声检查有助于发现窒息新生儿的脑异常,并有助于预测其神经发育结局。因此,可以制定适当的管理计划。
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