| Sub-title | |
| Authors | P Soler D Soler R Parascandalo |
| Abstract | Aims: To review the coverage of cranial ultrasounds in sick neonates admitted between October 1997 and October 1999 comparing this to recommended guidelines. Methods: A Medline review (1976-2005) was performed to assess the value and timeliness of screening neonatal cranial ultrasounds. Results: Recommendations are to perform first scan for preterms at high risk of intraventricular haemorrhage in first 72 hours and follow up at 14 days. In those with birth / perinatal asphyxia, first scan should be performed in the first 24 hours and follow up at 6-8 weeks. Early scans within the first 96 hours are important to detect lesions of antenatal origin. In our preterm group 99 (58%) underwent the first ultrasound scan within 72 hours of life. By the end of the first week, 126 (80%) preterm and 94 (84%) term underwent first cranial scan. A second scan was performed in the 2nd week in 40 %( 63) of preterms. First timely scans were performed in 64% of term infants with hypoxic ischaemic encephalopathy and 44% had a follow up scan booked on the SCBU at 4-6 weeks. Conclusion: Adhering to the optimal timing of scanning is difficult. Just over half of preterm infants had early scans which could result in missing transient lesions like flares / early hemorrhages in those unscanned. Most preterms had a scan by the first week, the time when virtually all haemorrhages will be detected. Coverage of term infants with second ultrasound is low as most would have been discharged before 4-6 weeks. The latter require improved 6-8 week ultrasound coverage. |
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| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | audit, cranial, recommendations, SCBU, ultrasound, neonate |