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Early postnatal color Doppler changes in neonates receiving delivery room resuscitation with low 5 min Apgar score—a pilot study

Journal of Perinatology volume 41, pages 486–493 (2021)Cite this article

Subjects

Abstract

Aims and objectives

To evaluate the Doppler changes in the intracranial arteries of neonates exposed to perinatal hypoxic insult and compare it with normal neonates.

Materials and methods

Color Doppler of bilateral anterior and middle cerebral arteries was performed within 6 h of birth in 26 healthy neonates and 50 neonates who received delivery room resuscitation (DRR) for perinatal depression and had a 5 min Apgar score <7. Comparisons of resistive index (RI) and peak systolic velocity (PSV) were made between the (a) control group (b) patients with low 5 min Apgar score <7 who without clinical features of neonatal encephalopathy at 24 h (c) neonates with perinatal depression with a clinical evidence of disturbed neurological function at 24 h of birth and examination consistent with mild, moderate, or severe encephalopathy using modified Sarnat and Sarnat’s classification.

Results

Significantly higher RI was observed in the neonates with to perinatal depression compared to the normal neonates. Significantly higher RI was seen in the patients with clinical features of neonatal encephalopathy (Group C) compared to group B. RI <0.6 and >0.82 was associated with severe neonatal encephalopathy. Differences in PSV were not statistically significant in the various groups.

Conclusion

The study presents the changes in early cerebral Doppler parameters observed in neonates with low 5 min Apgar score following DRR compared to the normal neonates. We also present the relations of Doppler parameters with increasing severity of neonatal encephalopathy according to Sarnat classification.

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Fig. 1: Scatter plot of RI values of the four intracranial arteries (y-axis) in various study groups (x-axis).
Fig. 2: Receiver operated characteristic (ROC) curves to predict severe neonatal encephalopathy.

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Authors and Affiliations

  1. Departments of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

    Ishan Kumar, Shweta Singh, Ram C. Shukla & Ashish Verma

  2. Division of Neonatology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

    Ashok Kumar

  3. Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

    Priyanka Aggarwal

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  1. Ishan Kumar
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Correspondence to Ashish Verma.

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Kumar, I., Singh, S., Kumar, A. et al. Early postnatal color Doppler changes in neonates receiving delivery room resuscitation with low 5 min Apgar score—a pilot study. J Perinatol 41, 486–493 (2021). https://doi.org/10.1038/s41372-020-00882-x

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