Trans-cranial Doppler in prediction of adverse outcome in asphyxiated neonates

Abstract

This study identified the association between middle cerebral artery (MCA) flow changes in first 6 h of life and death or abnormal neurological examination at 3 mo of corrected age in asphyxiated neonates of gestation ≥ 34 wk. Sixty neonates with asphyxia and hypoxic ischemic encephalopathy underwent a cranial Doppler within 6 h of life and were followed till 3 mo of age. Nineteen infants (32%) had the primary outcome at 3 mo. The median MCA-end diastolic velocity (EDV) was significantly higher in babies with adverse outcome. The risk of a combined adverse outcome was 2.6 and 2.7 times more in infants with an abnormally elevated MCA- EDV and decreased MCA-pulsatility index (PI) respectively. A low PI had a specificity of 97% for the combined adverse outcome. In conclusion, An abnormal MCA-EDV and PI measured within first 6 h of life were significantly associated with death or abnormal neurological examination at 3 mo.

Keywords

Middle cerebral artery - flow velocities - asphyxia - neonates - outcome - prediction