General triplex ultrasound (abdominal, cardiac, thyroid, head and hip joint) as a screening method of newborns and infants in the pediatrics and family doctor's office
Purpose: Newborns screening means certain”complex medical investigations”, which aims are to detect or rule out early in infants, more severe disease that is essential for the immediate commencement of treatment. Number of diseases, included in screening, varies from country to country, between 30 to 50, mostly congenital metabolic and endocrine diseases and this are done in hospital.
Material and methods: Our prospective study includes several 800 apparently healthy newborns. Each infant was examined by ultrasound, initial at two weeks, followed by 16 weeks control. We started the general ultrasound examination of the abdominal region, of the right hypochondria counterclockwise, on standard sections and plans. Next we examined other regions: cardiac, thyroid, head, hip all this in fast mode in our standard sections. We followed an ultrasound protocol, designed by us, for all newborns and infants included, identifying our anatomical sections.
Results: Ultrasound has been an useful diagnostic method for investigating malformations and tumors, topography establishing, expanding, consistency and semiologic elements related to their structure (sensitivity 78%, specificity 90%). We identified in the malignant tumors, the emergence of a rich vasculature, vessel neoformation, both the periphery and inside the node, vessels and their differentiation areas of necrosis and intratumoral hemorrhage. Malignant tumors 0.5%, account for about two thirds of all primary tumors in infants. Liver tumors are number three in incidence, after Wilms' tumor and neuroblastoma. Congenital malformations of newborns studied was 7%. The most common are vascular malformations, followed by regression, of the cardiac, kidney, congenital dislocation of the hip. Hypoxic ischemic encephalopathy is an entity becoming more common in infants 4%, with subsequent neuropsychological consequences.
Conclusion: We mention that triplex Doppler sonography is useful, in detection of congenital malformations, tumors, vascular-ischemic-hemorrhagic lesions and infectious and monitoring newborns and infants, allowing their enrollment in early diagnosis with definite prognostic value.