Resistive index (RI) as a prognostic indicator of early morbidities in term neonates with hypoxic ischemic encephalopathy

G. S. Gowthami; M. M. Patil; Ravi Kumar Yeli; S. S. Kalyanshettar; S. V. Patil; Siddu Charki

doi:10.53730/ijhs.v6nS6.12721

Authors

Gowthami G. S. Neonatology Fellow (NNF), Department of Paediatrics, BLDE (DU), Shri B M Patil Medical College & Research Centre, Vijayapur, Karnataka
Patil M. M. Professor, Department of Paediatrics, BLDE (DU), Shri B M Patil Medical College & Research Centre, Vijayapur, Karnataka
Ravi Kumar Yeli
ravi.kumar@bldedu.ac.in
Assistant Professor, Department of Radiology, BLDE(DU), Shri B M Patil Medical College & Research Centre, Vijayapur, Karnataka
Kalyanshettar S. S. Professor and HOD Department of Paediatrics, BLDE (DU), Shri B M Patil Medical College & Research Centre, Vijayapur, Karnataka
Patil S. V. Professor and Vice Dean, Department of Paediatrics, BLDE (DU), Shri B M Patil Medical College & Research Centre, Vijayapur, Karnataka
Siddu Charki Consultant Neonatologist, Department of Paediatrics, Shri B M Patil Medical College & Research Centre, Vijayapur, Karnataka

Keywords:

resistive index, hypoxic ischemic encephalopathy, term neonates, neonatal morbidity, colour doppler cranial ultrasound

Abstract

Background: Hypoxemia and hypoxia sustained by neonates during birth process leads to Hypoxic-ischemic encephalopathy (HIE) which can give rise to immediate and/or long term sequelae of neonatal brain injury, increased neonatal morbidity and mortality worldwide. Material and methods: A prospective observational study done in tertiary neonatal intensive care unit of north Karnataka region. The study was conducted between September 2021 to May 2022. Results: A total of 44 neonates with HIE were studied. There were 26 (61%) male and 18 (39%) female babies and the male to female ratio was 1.4:1. There were 28 cases with grade I, 6 cases with grade II and 10 cases with grade III HIE. The Resistive index was normal in 30 (68.1%) cases and was abnormal in 14 (31.8%) cases. Common Doppler ultrasound findings were of increased echo density of cerebral parenchyma and increased periventricular density. There were 95% survivors and 5% deaths due to HIE. The most common complications were of acute kidney injury (34%) and seizures (11.4%).

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References

Alexander L. Loomis; Mathew N. Chakko. Doppler Trans-Cranial Assessment, Protocols, And Interpretation. Treasure Island (FL) NCB Stat Pearls [Internet] Jan 2022.

Barseem NE, Badr HS, Abdullah MS. Color Doppler ultra sonography in full term neonates with hypoxic ischemic ence phalopathy and prediction of outcome. Egypt Pediatr Assoc Gazette. 2016;64:38–43.

Cassia GS, Faingold R,Bernard C,Sant’Anna GM. Neonatal hypoxic –ischemic injury:sonography perfusion of the brain and abdomen with pathologic correlation. Am J Roentgenol.2012;199(6):743-52.

Di Muzio, B., Saber, M. Neonatal hypoxic-ischemic encephalopathy. Reference article, Radiopaedia.org. Sept 2021. https://doi.org/10.53347/rID-12856.

Edwards AD, Brocklehurst P, Gunn AJ, Halliday H, Juszczak E, Levene M, et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic-ischaemic encephalopathy: synthesis and meta-analysis of trial data. BMJ, 340 (2010), p. c363.

Guan B, Dai C, Zhang Y, Zhu L, He X, Wang N. Early diagnosis and outcome prediction of neonatal hypoxic-ischemic encepha lopathy with color Doppler ultrasound. Diagn Inter Imaging. 2017;98:469–75.

Jain H, Arya S, Thakur K, Joshi S, Study of transcranial colour Doppler in the measurement of cerebral edema in birth asphyxia : Int J Pediatr Res 2016;3(4):274-277.doi:10.17511/ijpr.2016.4.012.

Kumar AS, Chandrasekaran A, Asokan R, Gopinathan K. Prognostic Value of Resistive Index in Neonates with Hypoxic Ischemic Encephalopathy. Indian Pediatr. 2016 Dec 15;53(12):1079-1082.

Lawn JE, Lee AC, AM M, Sibley L, Carlo WA, Paul VK, et al. Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done? Int J Gynaecol Obstet. 2009;107(Suppl 1):S5–18.

Likitha N, Channabasavanna N, Mahendrappa KB. Immediate complications of hypoxic ischemic encephalopathy in term neonates with resistive index as prognostic factor. Int J Contemp Pediatr 2021;8:711-5.

Michniewicz B, Al Saad SR, Karbowski LM, Gadzinowski J, Szymankiewicz M, Szpecht D. Organ Complications of Infants with Hypoxic Ischemic Encephalopathy Before Therapeutic Hypothermia. Ther Hypothermia Temp Manag. 2021 Mar;11(1):58-63.

Power, Bronwyn et al. “The Modified Sarnat Score in the Assessment of Neonatal Encephalopathy: A Quality Improvement Initiative.” Irish medical journal 112 7 (2019): 976.

Ristovska S, Stomnaroska O, Danilovski D. Hypoxic Ischemic Encephalopathy (HIE) in Term and Preterm Infants. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022 Apr 22;43(1):77-84

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. Arch Neurol, 33 (1976), pp. 698-705.