[Neonatal ultrasonographic cerebral findings: association with risk factor for cerebral palsy].

BACKGROUND

Is it possible to identify patients with cerebral palsy (CP) with postnatal ultrasound scan? Which risk factors are associated with an increased risk of CP?.

PATIENTS AND

METHODS

The data of 37 children with CP, who were sonographically investigated during the first 24 hours of life were analyzed retrospectively. The data of 21 preterm infants with gestational age </= 32 wk were compared with the data of 59 without CP.

RESULTS

A tetraparesis was found in 15/21 of preterm babies </= 32 wk, a hemiparesis in 4/8 of premature infants >/= 33 wk and in 5/8 of the mature babies. The mature babies had prenatal brain atrophy or hypoxic-ischaemic cerebral lesions. Cytomegaly and encephalitis were detected in two babies. Immature babies >/= 33 wk showed prenatal porencephaly or encephalomalacia after asphyxia. Premature babies </= 32 wk had cystic periventricular leucomalacia (n=12) or cerebral haemorrhage (n=3); 3 babies had meningitis. Only two prematures </= 32 wk with mild CP had inconspicuous ultrasound scans. Factors associated with cerebral palsy were: cystic periventricular leucomalacia (OR 24,89; 95 % CI: 5,85 - 105,87), cerebral atrophy (OR 4,84; 95 % CI: 1,61 - 14,51), fetal hypoxia (CTG) - (OR 4,78; 95 % CI: 1,31 - 17,45), abruptio placentae (OR 4,32; 95 % CI: 1,16 - 16,13), anemia after birth (OR 18,13; 95 % CI: 1,97 - 166,43), abnormal neurological behavior at term (OR 14,00; 95 % CI: 3,29 - 59,55).

CONCLUSION

Cerebral ultrasound scan after birth is a useful method detect for cerebral lesions in patients with CP-risks.