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Cranial Colour Doppler and Electroencephalogram as Early Prognostic Markers in Babies with Hypoxic Ischaemic Encephalopathy: A Prospective Cohort Study |
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Jayendra Arya, Saurabh Patel, Amaresh Shukla, Deepak Dwivedi 1. Senior Resident, Department of Paediatrics, Shyam Shah Medical College, Rewa, Madhya Pradesh, India. 2. Associate Professor, Department of Paediatrics, Shyam Shah Medical College, Rewa, Madhya Pradesh, India. 3. Associate Professor, Department of Radiodiagnosis, Shyam Shah Medical College, Rewa, Madhya Pradesh, India. 4. Professor, Department of Paediatrics, Shyam Shah Medical College, Rewa, Madhya Pradesh, India. |
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Correspondence Address : Deepak Dwivedi, D-2/8 Doctors Colony Rewa (M.P.) Pin 486001, Rewa, Madhya Pradesh, India. E-mail: deepakdwi72@gmail.com |
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| ABSTRACT |  | ||||||
: Introduction: Birth asphyxia continues to be a leading cause of neonatal morbidity and mortality globally. Early detection of ischaemic changes through Doppler ultrasound and Electroencephalography (EEG) may play a crucial role in prompt management, timely referral and effective parental counseling. Aim: To evaluate role of Cranial colour doppler and EEG background activity in prediction of short and long-term outcome in term newborn with Hypoxic–Ischaemic Encephalopathy (HIE). Materials and Methods: The present prospective cohort study was carried out in S.S. Medical College and SGM Hospital in central India during January 2020 to June 2022. A total of 71 full term neonates with HIE gone through Cranial Doppler and conventional EEG minimum for 1 hour within 6 hours of birth. Hammersmith Neonatal Neurological Examination (HNNE) was performed at the time of discharge and neurodevelopmental assessment at follow-up visit was done using Hammersmith Infant Neurological Examination (HINE) and Developmental Assessment Scales for Indian Infant (DASII). Association between EEG background activity and HNNE score, HINE score and neurodevelopmental outcome (cerebral palsy, epilepsy and developmental delay) was calculated. Chi-square test and Analysis of Variance (ANOVA) test was done and p-value <0.05 was considered significant. Results: Among babies with abnormal Doppler scan, 26 (92.8%) have bad short-term outcome, similar result were seen with abnormal Doppler and abnormal EEG in which 26 (94%) and 11 (84%) have bad short-term outcome (abnormal HNNE) respectively. After combining all modalities 23 (100%} babies showed bad outcme on short-term basis with p-value <0.05. Mean HNNE and HINE score was significantly lower (p-value=0.001) in newborns with abnormal doppler and severely abnormal EEG as compared to normal Doppler and normal EEG group. A severely abnormal EEG at birth was significantly associated with cerebral palsy (p-value=0.0005), epilepsy (p-value=0.04) and developmental delay (p-value=0.001). Conclusion: Cranial colour doppler with EEG within 6 hours of birth in term HIE babies had high sensitivity and negative predictive value in predicting neurodevelopmental outcome. | |||||||
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| Keywords : Cerebral palsy, Developmental delay, Epilepsy, Neurodevelopmental outcome | |||||||
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DOI and Others :
DOI: 10.7860/IJNMR/2025/76902.2448
Date of Submission: Nov 21, 2024 Date of Peer Review: Feb 24, 2025 Date of Acceptance: May 15, 2025 Date of Publishing: Sep 30, 2025 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. NA PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Nov 22, 2024 • Manual Googling: May 10, 2025 • iThenticate Software: May 13, 2025 (4%) ETYMOLOGY: Author Origin EMENDATIONS: 8 |
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