Early detection of Central Nervous System (CNS) abnormality by Neurosonography in critically ill neonates.

Abstract

Background: Neurosonography has commonly used for screening in a tertiary level hospital with a neonatal intensive care unit (NICU), for early detection of Central Nervous System (CNS) defects like intra-ventricular haemorrhage (IVH), hydrocephalus, cerebral edema or any structural anomalies. in the neonates brain. Aim: To study the detection of Central Nervous System (CNS) abnormality by neurosonography in critically ill neonates. Materials and methods: This was a cross sectional study done in NICU, AVBRH, Sawangi Meghe. By taking detailed maternal history and clinical examination, neonate is described as “critically ill”. These neonates subjected to neurosonogram (NUSG) according to the inclusion and exclusion criteria as per the protocols and various anomalies noted. Gestational age, birth weight, clinical examination, investigation, neurosonography finding and outcome were evaluated. Results: Neurosonography performed in 105 critically ill neonates. Out of that, 21 had abnormal neurosonography finding. There was no significant correlation of birth weight and gestational age of high-risk neonate with abnormal neurosonograpy (p=0.538 & p=0.130). The most frequent clinical manifestation was RDS followed by neonatal seizure. The mean HR,RR, SBP,DBP and SpO2 were 140±19.81, 54.08±13.07, 90.96±8.66, 54.13±8.39 and 94.39±6.93 respectively. There was no statistically significant correlation between the vital parameters and the presence of abnormalities on neurosonography. On neurosonography, 20% of neonates had abnormal findings. About 8.57% of these had hydrocephalus, 6.6% Intraventricular haemorrhage, 1.90% has periventricular echogenicity, 0.95% had cerebral oedema, 0.95% had germinal matrix haemorrhage and 1% had brain abscess. Seventy-two neonates (68.57%) participate had positive outcome at the time of NICU discharge and 19(18.10%) were died. Conclusion: Neurosonography is a useful tool in NICU. It is acceptable and reliable modality to screen critically ill neonates and aid in early detection and management of these ill neonates.