Transcranial Doppler in hypoxic-ischemic encephalopathy babies as a prognostic marker in the short-term outcome

Abstract

Background: Birth asphyxia is a lack of blood flow or gas exchange to or from the fetus in the period immediately before, during, or after the birth process. Birth asphyxia can result in profound systemic and neurologic sequelae due to decreased blood flow and/or oxygen to the developing fetus or infant. Birth asphyxia is one of the most common causes of neonatal mortality and morbidity globally. Aims and Objectives: The aims of this study were to assess the importance of cranial Doppler as investigation tool for the early prognostic marker of babies with hypoxic-ischemic encephalopathy (HIE) in short term. Materials and Methods: This prospective study was carried out in a tertiary care teaching hospital. The present study includes 50 newborns, out of which 30 newborns admitted with birth asphyxia were considered as a case, while 20 healthy term newborns were taken as control. Transcranial Doppler of middle cerebral artery (MCA) was done on day 1 of life. They were followed up at discharge for neuromotor outcome by Hammersmith Neonatal neurological examination (HNNE). The outcome was correlated with, Doppler findings of MCA. P<0.05 was taken significant. Results: Abnormality detected by transcranial Doppler within 24 h of life in neonates with birth asphyxia was significantly associated with poor neuromotor outcome when compared to healthy term neonates. HNNE score in HIE babies was lesser than healthy term neonates on discharge. Conclusion: Cranial Doppler within 24 h of birth in term HIE babies has very high sensitivity in predicting short-term outcome in babies with HIE, such as Low HNNE score.

Keywords

• doppler; hammersmith neonatal neurological examination; hypoxic-ischemic encephalopathy