Significance of cranial ultrasound in the diagnosis of intraventricular haemorrhage in premature neonates

Aim: to determine the frequency of intraventricular haemorrhage (confirmed by ultrasound) in clinically suspected premature neonates. study design: descriptive study. subjects & methodology: the study was conducted at the department of radiology,children hospital,institute of child health,lahore from 17-02-2012 to 16-02-2013. a total of 116 premature neonates with maternal gestational age less than 37 weeks,birth weight less than 2.5 kgs,and of both the sexes were included in this study. cranial ultrasound was carried out in all neonates using standard coronal and parasagittal images,using 5 m hz transducer through anterior fontanellae. staging was performed using the grading suggested by papil et al. grade-i haemorrhage is confined to the subependymal matter. grade-ii haemorrhage is an intraventricular haemorrhage without ventricular dilatation. grade-iii haemorrhage is an intraventricular haemorrhage with ventricular dilatation. grade-iv haemorrhage is intraparenchymal. the baseline threshold set by ultrasound machine to determine ivh more than 5 mm. a water soluble gel (aqua sonic) was used as a coupling agent. the following data was collected about gestational age,birth weight,sex,ultrasound grading and neonatal age (hours). results: out of 116 cases,intraventricular haemorrhage was found in 19 patients (16.4%). mean gestational age was 32.7±6.7 and 33.1±7.2 weeks with and without ivh,respectively. most babies developed ivh between 24-48 hours of life i.e. 47.4%. eleven babies (31.6%) developed ivh in first 24 hours and 2 babies (21.0%) developed ivh after 48 hours of life. regarding various grades of ivh,out of 19 neonates with ivh,6 neonates (31.6%),10 babies (52.6%),2 babies (10.5%) and 1 baby (5.3%) had grade-i,grade-ii,grade-iii and grade-iv haemorrhage respectively. conclusion: the frequency of intraventricular haemorrhage in clinically suspected premature neonates is high in cases with low gestational age and low birth weight. the ultrasonic grading was directly related to the clinical signs and symptoms of the patients.