Utility of performing routine head ultrasounds in preterm infants with gestational age 30-34 weeks

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Medical Imaging

Background:

• Current guidelines recommend routine head ultrasounds (HUS) for preterm infants under 30 weeks gestation.
• The incidence and clinical significance of abnormalities in slightly older preterm infants remain less defined.

Purpose of the Study:

• To determine the incidence of intraventricular hemorrhage (IVH) in preterm infants between 30-34 weeks gestational age (GA).
• To evaluate the necessity of routine screening head ultrasounds (HUS) for this specific preterm infant population.

Main Methods:

• A retrospective study included preterm infants with GA of 30-34 weeks admitted to the NICU from January 1997 to September 2007.
• Intraventricular hemorrhage (IVH) grading followed the established Papile classification system.

Main Results:

• Screening HUS were performed on 463 infants (GA 30-34 weeks).
• Overall, 5.8% of infants showed abnormal cranial ultrasound findings, including IVH or periventricular leucomalacia (PVL).
• Severe abnormalities (Grade III/IV IVH or PVL) were identified in 1.5% of infants.

Conclusions:

• A notable proportion of preterm infants born between 30-34 weeks gestation exhibit cranial ultrasound abnormalities.
• Potential selection bias may have overestimated the incidence of HUS abnormalities as not all infants received screening.
• Further research is required to assess neurodevelopmental outcomes in preterm infants with mild IVH (Grades I/II) before endorsing routine screening for this group.