Preterm cranial ultrasound scanning is both feasible and effective in a middle-income country.
AIM
Cranial ultrasound is seldom used in middle-income countries, and the burden of preterm brain injury and its relationship to perinatal data is unknown. We assessed cranial ultrasound abnormalities in very low-birthweight (VLBW) infants and correlated the findings with perinatal data.


METHODS
VLBW Armenian infants receiving neonatal intensive care in 2012 were scanned from birth to term-equivalent age (TEA). Clinical data were collected prospectively.


RESULTS
We studied 100 VLBW infants with a median gestation of 30 weeks. Periventricular white matter echogenicity (PVE) lasting more than two weeks was seen in 34 infants, grade III intraventricular haemorrhage (IVH) in 10, haemorrhagic parenchymal infarction (HPI) in seven and cystic periventricular leukomalacia in two. Caudothalamic notch echogenicity appeared in 36 infants after two to three weeks, with cystic transformation in 22. At TEA, 17 infants had persisting PVEs and 55 had increased basal ganglia/thalamic (BGT) echogenicity. Lack of antenatal steroids was significantly associated with IVH and HPI and intubation at birth with IVH. Late BGT echogenicity was generally seen in infants without perinatal problems.


CONCLUSION
Our study demonstrated that cranial ultrasound can be used effectively in a middle-income country to identify high-risk infants and monitor quality of care.
['Mazmanyan|Pavel A|PA|', 'Nikoghosyan|Knarik V|KV|', 'Kerobyan|Varsenik V|VV|', 'Mellor|Kathy J|KJ|', 'Diez-Sebastian|Jesus|J|', 'Martinez-Biarge|Miriam|M|', 'Cowan|Frances M|FM|']
D001238:Asphyxia Neonatorum D001921:Brain D005240:Feasibility Studies D005260:Female D006801:Humans D007231:Infant, Newborn D007363:Intensive Care Units, Neonatal D015931:Intensive Care, Neonatal D008297:Male D014463:Ultrasonography
Preterm Middle-income country Neonatal intensive care Intraventricular haemorrhage Cranial ultrasound imaging