doiSerbia

Predictive value of color doppler neuro-sonography for the development of neurological sequels in newborn infants with hypoxic ischemic encephalopathy

Vasiljević Brankica (Klinički centar Srbije, Institut za ginekologiju i akušerstvo, Beograd)
Maglajlić-Đukić Svjetlana (Univerzitetska dečija klinika, Beograd)
Stanković Sanja (Klinički centar Srbije, Institut za biohemiju, Beograd)
Lutovac Dragana (Klinički centar Srbije, Institut za biohemiju, Beograd)
Gojnić Miroslava (Klinički centar Srbije, Institut za ginekologiju i akušerstvo, Beograd)

Background/Aim. The use of color Doppler neurosonography (cD-US) allows simultaneous examination of parenchymal and vascular cerebral structures. Evaluation of cerebral blood flow velocities (CBFV) and vascular resistance are important in assessment of cerebral circulation in neonates with hypoxic ischemic encephalopathy (HIE). The aim of this study was to evaluate the predictive value of cD-US for abnormal neurodevelopmental outcome in the neonates with HIE. Methods. A total of 90 neonates (>32 weeks gestational age) with HIE were enrolled prospectively. All the neonates with HIE were categorized into three grades according to the Sarnat and Sarnat clinical staging system: mild HIE, moderate HIE, and severe HIE. cD-US was performed simultaneously during the first 24 h of life. Neurodevelopment outcome was assessed at 12 months of age in all the neonates. Resluts. The values of CBFV and the values of index resistance (RI) correlated with the severity of HIE (p < 0.0001) and subsequent neurodevelopmental outcome (p < 0.001). We detected a significant difference in values of CBFV and in values of RI between preterm and full-term neonates (p < 0.01). The cut-off value of RI for poor neurodevelopmental outcomes was 0.81. Conclusions. cD-US could be very useful and safe diagnostic tool for assessing severity of HIE and subsequent adverse neurodevelopmental outcome.

Keywords: ultrasonography, doppler, transcranial, infant, newborn, hypoxia-ischemia, brain, prognosis, preterm birth, cerebral palsy