Utility of performing routine head ultrasounds in preterm infants with gestational age 30-34 weeks.

BACKGROUND

The American Academy of Neurology and Child Neurology Society recommend performing routine screening head ultrasounds (HUS) on preterm infants of less than 30 weeks gestation.

OBJECTIVE

To study the incidence of intraventricular hemorrhage (IVH) and evaluate the need for screening HUS in preterm infants with gestational age (GA) of 30-34 weeks.

DESIGN/METHODS: Preterm infants (GA; 30-34 weeks) admitted to the neonatal intensive care unit (NICU) between January 1997 and September 2007 were included in this study. Grades of IVH were defined as per the Papile classification.

RESULTS

Screening HUS were performed on 463 infants with GA of 30-34 weeks. Twenty-seven (5.8%) infants had abnormal cranial ultrasound (US) (IVH or periventricular leucomalacia [PVL]). The incidence of IVH ranged from 3.3% to 6.3% at various GA. Seven (1.5%) infants had severe abnormalities on HUS (grades III/IV or PVL).

CONCLUSIONS

A significant number of infants born between 30 and 34 weeks of gestation have abnormalities on screening cranial US. Since not all infants born at 30-34 weeks of gestation received a HUS, the incidence of HUS abnormalities might have been overestimated due to a possible 'selection bias'. Additional studies are needed to examine the adverse neurodevelopmental outcomes in this group of preterm infants with mild abnormalities (IVH grades I or II) on cranial US before recommending routine screenings for IVH.