Medicinski pregled · 1999
[A 3-year study of ultrasound examination of the central nervous system in high risk neonates at the hospital in Senta].
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Vekonj-Fajka G, Molnar-Sabo I
Аннотация
INTRODUCTION: Transfontanellar neurosonography is a noninvasive, precise method for detection and follow-up of morphological and functional changes of the central nervous system in infants and newborn infants, which has been used as sonoscreening since 1996 in General Hospital in Senta in high-risk infant newborns.
MATERIAL AND METHODS: In the period 1996-1998 there were 2831 newborn infants at the Labor and Delivery Department. There were 551 (19.46%) newborn infants in the high-risk group. Ultrasonographic examinations of the brain were performed by SIEMENSSONOLINE SL2 apparatus, with a sector probe 3.5 Mhz. Out of the examined high-risk newborn infants 62.25% had a pathological ultrasound finding of the brain including: intracranial hemorrhage and hypoxic ischemic encephalopathies; 117 (21.23%) of newborn infants had intracranial hemorrhage Papile grade I-II; 66 (11.98%) newborn infants had III-IV grade intracranial hemorrhage and 160 (29.04%) had hypoxic ischemic encephalopathies.
DISCUSSION: Correlation between pathological CNS findings and Apgar Score (AS) in 143 newborn infants, revealed that all newborn infants with AS: 0-3 had a pathological finding of the brain: HIC or HIE (4 newborn infants). In the group with AS 4-7 (51 newborn infants) pathological sonogram was established in 44 (86.28%), whereas in the group with AS 8-10 (88 newborn infants) pathological ultrasound finding of CNS including HIC or HIE was registered in 40.09% of newborn infants. Changes in regard to HIC of various degree and HIE changes depend on the localization, volume, time of onset (vulnerable period) and spreading time. Compensatory mechanisms as well as great brain plasticity at this age and early rehabilitation can reduce the consequences of brain damages a great deal. That is why it is necessary to inform parents about the changes that have occurred properly in order to ensure correct relationship to their high-risk newborn infant. In this way they cooperate at check-ups and are able to follow the development of their child, noticing possible aggravation going on with multiple stimulation treatment.
MATERIAL AND METHODS: In the period 1996-1998 there were 2831 newborn infants at the Labor and Delivery Department. There were 551 (19.46%) newborn infants in the high-risk group. Ultrasonographic examinations of the brain were performed by SIEMENSSONOLINE SL2 apparatus, with a sector probe 3.5 Mhz. Out of the examined high-risk newborn infants 62.25% had a pathological ultrasound finding of the brain including: intracranial hemorrhage and hypoxic ischemic encephalopathies; 117 (21.23%) of newborn infants had intracranial hemorrhage Papile grade I-II; 66 (11.98%) newborn infants had III-IV grade intracranial hemorrhage and 160 (29.04%) had hypoxic ischemic encephalopathies.
DISCUSSION: Correlation between pathological CNS findings and Apgar Score (AS) in 143 newborn infants, revealed that all newborn infants with AS: 0-3 had a pathological finding of the brain: HIC or HIE (4 newborn infants). In the group with AS 4-7 (51 newborn infants) pathological sonogram was established in 44 (86.28%), whereas in the group with AS 8-10 (88 newborn infants) pathological ultrasound finding of CNS including HIC or HIE was registered in 40.09% of newborn infants. Changes in regard to HIC of various degree and HIE changes depend on the localization, volume, time of onset (vulnerable period) and spreading time. Compensatory mechanisms as well as great brain plasticity at this age and early rehabilitation can reduce the consequences of brain damages a great deal. That is why it is necessary to inform parents about the changes that have occurred properly in order to ensure correct relationship to their high-risk newborn infant. In this way they cooperate at check-ups and are able to follow the development of their child, noticing possible aggravation going on with multiple stimulation treatment.