Contributions of transfontanellar morphologic ultrasound to the evaluation of newborn brain injury in full-term neonates: A preliminary study

Abstract

Background and objectives: Neonatal brain injury represents a serious problem since it is one of the most common causes of morbidity and mortality of newborns, and a common cause of life-long neurological disability. Transfontanellar ultrasound (TFUS) remains the method of choice to explore the newborn brain. This study aimed to clarify the diagnostic and prognostic value of TFUS in the management of brain injury in the full-term neonates. Materials and Methods: A total of 151 newborns with a mean age of 6.1 days were retrospectively analyzed. We compared the evolution of pregnancy and the clinical data of newborns after delivery with the results of the TFUS findings. Results: We found that the major risk factors for term newborn brain injury were dystocia (88.8%, PPV, 80.9%, Se, 39.7% reached 85% in cases of dystocia) and primiparity (p=0.01). The main features found in TFUS were cerebral ischemia (45%), ventricular dilatation (28.3%), and cerebral hemorrhage (25%). Conclusion: Our results show that the clinical condition was not correlated with ultrasound lesions. Dystocia should imperatively prompt to US evaluation of the newborn brain. Routinely performed in cases of suspected neonatal brain damage, the combination of dystocia and a normal TFUS result should lead to the discontinuation of imaging studies.

Keywords

• Transfontanellar ultrasound
• Neonatal brain injury
• Dystocia