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Nonpathologic ventriculomegaly in the premature intrauterine growth retarded infant
1Department of Radiology, University of Kentucky Medical Center, Lexington 40536-0084, USA.
Insights
Premature infants with intrauterine growth restriction (IUGR) may show transient mild ventriculomegaly on head ultrasounds. This finding is typically nonpathologic and resolves over time in asymptomatic neonates.
Area of Science:
- Neonatal Neurology
- Pediatric Neuroimaging
- Perinatal Medicine
Background:
- Premature infants are susceptible to various neurological complications.
- Intrauterine growth restriction (IUGR) can impact neonatal neurodevelopment.
- Neurosonography is a key tool for evaluating the neonatal brain.
Purpose of the Study:
- To identify neurosonographic differences between premature infants with IUGR and those appropriate for gestational age (AGA).
- To characterize the nature and significance of ventriculomegaly in premature IUGR neonates.
Main Methods:
- Retrospective review of head sonograms from 36 premature IUGR infants and 32 premature AGA controls.
- Statistical analysis to compare the incidence of neurosonographic findings between groups.
Main Results:
- Mild ventriculomegaly was observed in 19% of IUGR infants versus 3% of AGA controls (p=0.05).
- No evidence of hemorrhage or ischemia was associated with ventriculomegaly in IUGR infants.
- Ventriculomegaly resolved in most IUGR infants within 4-12 weeks and was clinically asymptomatic.
Conclusions:
- Mild ventriculomegaly in asymptomatic premature IUGR infants without hemorrhage or ischemia is a transient, nonpathologic finding.
- Neurosonographic monitoring can help differentiate transient findings from significant pathology.
Objective:
To determine any neurosonographic differences between premature intrauterine growth retarded (IUGR) neonates and premature appropriate for gestational age (AGA) infants.
Study Design:
We retrospectively reviewed the head sonograms of 36 premature IUGR infants and 32 premature AGA matched controls.
Results:
Seven of the 36 (19%) IUGR infant head sonograms revealed mild ventriculomegaly with no evidence of hemorrhage or ischemia. Only one of the 32 control scans (3%) had similar findings. Mild ventriculomegaly in the IUGR infant versus the AGA control neonate was statistically significant (p value of 0.05). Follow-up head sonograms (4 to 12 weeks after the initial head sonogram) revealed resolution of the mild ventriculomegaly in five of the seven IUGR infants. Clinically, all of the IUGR infants with mild ventriculomegaly were asymptomatic during their stay in the nursery and in clinical follow-up ranging from 3 to 5 years.
Conclusion:
Mild ventriculomegaly on the head sonograms of asymptomatic premature IUGR infants (with no associated hemorrhage or ischemic change) should be recognized as a transient, nonpathologic finding.