Early detection of neonatal adrenal hemorrhage by ultrasonography

To investigate clinical features and course of neonatal adrenal hemorrhage (NAH) from July 1992 to August 1993, fifteen babies suffering from NAH born at Veterans General Hospital-Taipei were included. Portable ultrasound scanner was used for initial screening. The frequency of NAH was approximately 0.35% which is lower than other reports. The distribution of their birth weight was 3 cases lower than 3000 gm, 3 cases over 4000 gm and 9 cases within 3000 to 4000 gm. Only one was premature and another one post-term. Four of them had a history of either prenatal or perinatal asphyxia. Only one patient had a palpable abdominal mass. On the sonographic findings, eleven had bleeding in the right-side, two in the left-side and two in both sides. Only one had adrenal calcification. During their early life, no patient developed adrenal cortical insufficiency or secondary profuse bleeding. Two patients had pathologic jaundice. Two patients had severe anemia. After conservative treatment, none of them developed any severe complication. In conclusion, with the aid of renal sonoscreening in the newborn, we can discover NAH early and give adequate treatment at once. Severe complications also can be prevented.