This study identified the association between middle cerebral artery (MCA) flow changes
in first 6 h of life and death or abnormal neurological examination at 3 mo of corrected
age in asphyxiated neonates of gestation ≥ 34 wk. Sixty neonates with asphyxia and
hypoxic ischemic encephalopathy underwent a cranial Doppler within 6 h of life and
were followed till 3 mo of age. Nineteen infants (32%) had the primary outcome at
3 mo. The median MCA-end diastolic velocity (EDV) was significantly higher in babies
with adverse outcome. The risk of a combined adverse outcome was 2.6 and 2.7 times
more in infants with an abnormally elevated MCA- EDV and decreased MCA-pulsatility
index (PI) respectively. A low PI had a specificity of 97% for the combined adverse
outcome. In conclusion, An abnormal MCA-EDV and PI measured within first 6 h of life
were significantly associated with death or abnormal neurological examination at 3
mo.
Keywords
Middle cerebral artery - flow velocities - asphyxia - neonates - outcome - prediction
