The value of ultrasonography and Doppler sonography in prognosticating long-term outcomes among full-term newborns with perinatal asphyxia.
The aim of the study was to determine the correlation of hypoxic-ischemic (HI) brain injury in full-term neonates detected via ultrasonography (USG) and blood flow parameters evaluated via Doppler sonography (DS) with long-term outcomes of mental and neuromotor development at the age of 1-year.
In total, 125 full-term neonates (78 subjects of case group and 47 subjects of control group) were studied. During the first five days of life, the subjects daily underwent cerebral USG and DS. At the age of 1-year the neuromotor condition and mental development was evaluated.
The HI injury groups detected during USG significantly correlated with the mental development groups (r=0.3; P=0.01) and the neurological evaluation groups (r=0.3; P<0.001). In the presence of brain swelling (edema) and thalamus and/or basal ganglia (E/T/BG) injury, USG demonstrated high accuracy values when prognosticating spastic quadriparesis and severe mental development impairment in 1-year-old subjects: sensitivity - 100%, specificity - 93-100%, positive predictive value (PPV) - 60-100%, and NPV - 100%. In subjects with spastic quadriparesis, mean end-diastolic velocity (Vd) values were significantly higher (P≤0.05), and mean resistive index (RI) values were significantly lower (P<0.05) than those in subjects with normal neuromotor development. In subjects with severe mental retardation, mean Vd values in ACA were statistically significantly higher, and mean RI values in ACA and ACM were statistically significantly lower than those in subjects with normal mental development. Hypoxic-ischemic brain changes detected during ultrasonography and cerebral blood flow parameters associated with long-term outcomes of mental and neuromotor development at the age of 1-year.
Received 1 December 2013, accepted 9 May 2014, available online 27 June 2014.