Preterm newborns are known to have underdeveloped organs, which may not be ready to function outside of the uterus. They usually need care in a special nursery called the NICU (Neonatal Intensive Care Unit). Because many organs are underdeveloped, premature newborns may have difficulty breathing and feeding and are prone to bleeding in the brain, infections, and other problems.
Screening is a very essential step for doctors to detect the early complications inside a human body, including preterm newborns. There are few screening tests that must be taken by newborns, such as respiratory and digestive system screening, retinopathy of prematurity (ROP) screening, OAE or hearing screening, and lastly neonatal cranial ultrasound screening.
Ultrasound is a fast and effective procedure, making it ideal for premature infants. Since the late 1970s, cranial ultrasound examinations have been performed on premature babies to prove information about perinatal brain injury for the prediction of long term outcomes.
Preterm newborn’s brain is vulnerable to hemorrhagic (brain bleeding) and ischemic injury due to vascular, cellular and anatomical features of the developing brains, and the tendency for preterm newborn to experience periods of physiological instability at a time when they have limited cerebral circulatory autoregulation.
A very low birth weight infant who has multiple early complications is strongly advised to have diagnostic cranial ultrasound examinations by the third day of life. An ultrasound at this time provides important input for both short term and long term clinical management. Repeated ultrasounds should be performed, as clinically indicated in infants with identified brain injuries. Routine cranial ultrasound examinations are recommended at about the second and the sixth weeks of life to predict long term outcomes; early ultrasound examinations allow diagnosis of hemorrhagic lesions, and later ultrasound examinations can detect cystic lesions or ventriculomegaly.
Cranial ultrasound examinations can provide a safe and effective screening and diagnostic test of hemorrhagic and ischemic injury in premature infants. The major benefits of testing are to direct families of affected infants toward the most appropriate follow-up facilities to promote early diagnosis and intervention for chronic neurodevelopmental sequelae of hemorrhagic or ischemic brain injury, and to foster ongoing research activities that are aimed at ensuring the best possible outcomes for all infants.
The potential benefits and harmful consequences of misinterpreting cranial ultrasound examinations should be communicated to parents whose infants are undergoing the testing. Infants who have hemorrhagic lesions or any white matter or cystic lesions evident on cranial ultrasound examinations, require close, systematic follow-up after their discharge from NICU to facilitate the timely initiation of interventions.
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