ROLE OF TRANSCRANIAL DOPPLER PARAMETERS IN PRETERM NEONATES FOR PREDICTION OF INTRACEREBRAL HAEMORRHAGE.

Aims and Objectives: To assess the screening of intracerebral vessels in preterm newborns in early postnatal period by transcranial Doppler parameters; as a predictive method of identifying preterm infants at risk of intracerebral hemorrhage. The study is a Materials and Methods: prospective analytical observational study carried out on 50 preterm neonates; 23 male and 27 female, their gestational age (GA) ranged between 26 and 34 weeks, and their birth weights (BW) ranged from 1000 to 2500 g. Examination of the ACA and MCA were performed within the rst two days of life measuring PSV, EDV, MV and Doppler indices RI and PI. Then repeated within 4 to 7 days (follow up study). The neonates are classied into hemorrhagic and non-hemorrhagic / control groups and comparison of the Doppler parameters. The 50 preterm neonates Results: showed no intracerebral hemorrhage by transcranial ultrasound at the initial examination. On the follow up study, 25 of them developed ICH - hemorrhagic group and 25 of them did not develop ICH - control group. There was statistically signicant difference (P-value < 0.0001) between the two groups as regards; the gestational age <210 days, birth weight <1250 grams, mean value of EDV and RI in Doppler examination. Conclusion: The Doppler parameters were adequate enough to be used in the clinical practice to distinguish normal preterm neonates from those who might develop germinal matrix bleed / Intracerebral haemorrhage. The study showed that the most sensitive Doppler parameter which can be used as a predictor marker for intracerebral hemorrhage in preterm neonates during early postnatal period was RI < 0.64 and end diastolic velocity > 10.9 cm/s as a measurable screening predictor, when clinical symptoms of hemorrhage may be still silent and so preventive and therapeutic actions could be used