EVALUATION OF NEONATAL BRAIN HEMORRHAGE (NBH) BY TRANSCRANIAL ULTRASOUND IN PRETERM BABIES ADMITTED IN NICU

Background: Neurosonography (NSG), also known as transcranial ultrasound (TCU), is an essential bedside imaging tool for evaluating neonatal brain pathology, particularly in preterm infants. Neonatal Brain Hemorrhage (NBH), including Germinal Matrix Hemorrhage (GMH) and Intraventricular Hemorrhage (IVH), is a signicant cause of morbidity and mortality in preterm neonates. Early detection using NSG can aid in timely intervention and improve outcomes. This study aimed to evaluate neonatal brain hemorrhage (NB Aim: H) in preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) using transcranial ultrasound, determine the frequency and grading of NBH, assess associated risk factors, and analyze ultrasound ndings related to other neonatal brain abnormalities. Methods: A hospital-based observational study was conducted over 18 months at the Department of Radio-diagnosis, G.S.L Medical College, India. A total of 110 preterm neonates (gestational age <37 weeks) admitted to the NICU were included. Data on maternal history, perinatal events, neonatal factors, and imaging ndings were collected. Transcranial ultrasound was performed using a PHILIPS Afnity 70G machine with a high-frequency linear probe (7–12 MHz). Statistical analysis was conducted to evaluate the correlation between NBH, gestational age, birth weight, and clinical outcomes. Results Ÿ 62.7% of preterm neonates had abnormal TCU findings, while 25.45% had NBH. Ÿ NBH was more frequent in neonates <28 weeks gestation (47%) compared to 26.9% in 28–32 weeks and 14.6% in 33–36 weeks (p=0.03). Ÿ Low birth weight signicantly correlated with NBH, affecting 55.5% of very low birth weight (VLBW) infants (<1500g). Ÿ The most common ultrasound findings included GMH (23.1%), periventricular flare (18.8%), and IVH (15.94%). Ÿ 83% of NBH cases were detected within 72 hours of life. Ÿ Clinical complications were more frequent in NBH cases, including hypoxic-ischemic encephalopathy (HIE) (25%), post-hemorrhagic hydrocephalus (10.7%), and sepsis (7.14%), though mortality was not significantly impacted. Ÿ Neonates with NBH had signicantly lower APGAR scores at 1 minute (5.21±1.13) and 5 minutes (6.50±1.00) compared to those without NBH. Conclusion: Neurosonography is an effective non-invasive, bedside imaging modality for early detection of neonatal brain hemorrhage (NBH) in preterm infants. It remains the preferred primary imaging tool in NICUs due to its high sensitivity, bedside accessibility, and safety. Gestational age, low birth weight, and APGAR scores were signicant predictors of NBH. Early TCU screening in high-risk neonates can aid in better clinical decision-making and improved neonatal outcomes.