Effect of Routine, Screening Head Ultrasounds on Clinical Interventions for Premature Infants

Abstract

Objective This article assesses whether routine, screening head ultrasound (HUS) studies performed at 7 to 14 postnatal days for premature infants are followed by clinical interventions.

Study Design This retrospective cohort study included all inborn infants delivered at < 30 weeks' gestational age (GA) between January 1, 2012 and December 31, 2015 at a single center who had a routine, screening HUS performed between 7 and 14 postnatal days (n = 303). We defined “clinical intervention” as a 7 to 14 postnatal day HUS that was followed by neurosurgical intervention prior to a 36- to 40-week postmenstrual age (PMA) HUS or elective withdrawal of critical care within 30 days of a positive HUS finding.

Results Four infants (1.3%) had neurosurgical intervention prior to a 36- to 40-week PMA HUS; all four had a diagnostic HUS performed prior to postnatal day 7 to assess for an intraventricular hemorrhage (IVH) due to clinical instability. No infant had critical care electively withdrawn following a 7 to 14 postnatal day HUS.

Conclusion Clinical intervention rarely followed routine, screening HUS studies performed at 7 to 14 postnatal days for inborn infants delivered at < 30 weeks' GA. In no case did clinical intervention related to HUS results occur when a 7 to 14 postnatal day HUS was the initial HUS performed.

Keywords

premature - head ultrasound - screening - intraventricular hemorrhage - intervention

Authors' Contributions

A.H. conceptualized and designed the study, performed and coordinated data collection, drafted the initial manuscript, and approved the final manuscript as submitted. M.L. reviewed and revised the manuscript and approved the final manuscript as submitted. W.P. advised Dr. Heling in the design of the study, supervised the data collection, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Note

All authors agree that the material presented is original research and has not been previously submitted for publication.

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