Incidence of cranial ultrasound abnormalities in apparently well neonates on a postnatal ward: correlation with antenatal and perinatal factors and neurological status
a Department of Paediatrics and Neonatal
Medicine, Hammersmith Hospital, London W12 OHN, b Department of Obstetrics, Queen Charlotte and
Chelsea Hospital, Royal Postgraduate Medical School, London
Correspondence to: Dr Eugenio Mercuri.
Accepted 20 April 1998
AIM
To evaluate cranial ultrasonography and
neurological examination in a cohort of infants regarded as normal; and
to determine the prevalence of ultrasound abnormalities and any
potential association with antenatal or perinatal factors or deviant
neurological signs.
METHODSCranial ultrasound findings and
neurological status were evaluated in 177 newborns (gestational age
36.3 to 42 weeks), admitted to a postnatal ward directly after birth
and regarded as normal by obstetric and paediatric staff. The age of
the infants at the time of examination ranged between 6 and 48 hours.
Ultrasound abnormalities were present in 35 of the 177 infants studied
(20%). Ischaemic lesions, such as periventricular and thalamic
densities were the most common finding (8%), followed by haemorrhagic
lesions (6%). The possible sequelae of antenatal haemorrhages, such as focal ventricular dilatation or choroid cysts, were present in 6%.
Abnormal ultrasound findings were not significantly associated with
signs of perinatal distress, such as cardiotocographic abnormalities or
passage of meconium. Abnormal ultrasound findings tended to be
associated with antenatal problems, although this did not reach significance. Ultrasound abnormalities were strongly associated with
deviant patterns on the neurological examination.
CONCLUSIONSThese results suggest that
ultrasound abnormalities are more common than has been reported up to
now. Lesions that could be ischaemic, such as flare densities, are seen
even in the absence of any antenatal or perinatal risk factor.
© 1998 by Archives of Disease in Childhood
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