Ultrazvučni nalaz na mozgu novorođenčadi sa intrauterusnim zastojem u rastu

Abstract

Intrauterine growth restriction is associated with increased neonatal morbidity and mortality, childhood neurodevelopmental disorders, and the onset of illness in adulthood. The aim of this study is to analyze the ultrasound findings on the brain of infants with intrauterine growth restriction. Also, determine if there is a difference in ultrasound findings between infants with intrauterine growth restriction and a control group comprised of infants with adequate intrauterine growth. In a prospective analysis, 100 infants from 32 to <39 gestational weeks were examined: 70 with intrauterine growth restriction and 30 as a control group. Ultrasound analysis was performed twice, during the first 3 days and from 7 to 10 day. Lateral ventricles size, periventricular echogenicity and occurrence of periventricular leukomalacia, presence of intracerebral hemorrhages, resistance index, cysts, septum pelucidum and corpus callosum, occurrence of brain atrophy, presence of septa and calcifications were analyzed. Cranial ultrasound of intrauterine growth restricted neonates revealed the following changes, from the most common to the most rare: periventricular hyperechogenicity, resistance index changes, periventricular-intraventricular hemorrhage, ventricular index changes, periventricular leukomalacia, talamo-okcipital distance changes, choroid plexuses cysts, choroid plexus hemorrhage, anterior horn width changes, subependymal cysts, pelucid septum lack. Comparing the two groups we found the next statistical difference: a) periventricular hyperechogenicity, resistance index changes and presence of periventricular-intraventricular hemorrhage were present in the group of intrauterine growth restricted neonates with a highly statistically significant difference (p<0.001) compared to the control group, b) changes in the ventricular index and periventricular leukomalacia, were present in the group of intrauterine growth restricted neonates with a statistically significant difference compared to the control group (p<0.01 and p<0.05), c) differences in the frontal horn size and thalamo-occipital distance, presence of choroid plexus cysts, choroid plexuses hemorrhage, subependymal cysts, and pelucid septum lack were not present between the studied groups (p˃0.05). Differences in the presence of changes in the brain as a whole, in the group of intrauterine growth restricted neonates were present with a highly statistically significant difference (p<0.001) compared to the control group.