Preterm screening by transfontanelar ultrasound - results of a 5 years cohort study

Intracranial hemorrhages (ICH) might be the cause of significant psycho-motor or cognitive impairment in preterm babies. A 5 year cohort study performed in the IOMC was aimed at determining the prevalence and proportion of the main types of ICH diagnosed by transfontanelar (TF) ultrasound among admitted preterms, along with the neuro-developmental effects on a 12 month follow-up period.

In the above mentioned period all enrolled newborns were examined by TF ultrasound according to a common standardized protocol. The 4 grade Papile ICH classification was used for all examined subjects. In order to determine the potential neurological sequels we performed a 12 month neurological follow-up of all 292 patients in the study group.

The prevalence of all types ICH diagnosed by systematic TF ultrasound was 20.4 %. The most prevalent type of ICH was peri-intraventricular: 40% grade I and 33 % grade II, with no major neurological sequels For both the correlation to the neurological outcome was statistically significant (p < 0.05). Severe neurological sequels were associated with grade III and IV, but the correlation was found to be statistically significant (p < 0.05) only for grade IV hemorrhages. A severe neurological outcome was of statistical significance only for the cerebellar hemorrhage outcome, although a similar pattern was also observed for the thalamic hemorrhages.

Systematic TF screenings for preterm is useful for early diagnosis and staging which might improve the management of rehabilitation therapies, and provide appropriate information on the disease outcome as well as influencing the quality of parental counseling.