Journal of Ultrasound in Medicine, Vol 13, Issue 8 595-600, Copyright © 1994 by American Institute of Ultrasound in Medicine
Cerebral artery Doppler ultrasonography for prediction of outcome after perinatal asphyxia
J. E. Stark and J. J. Seibert
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Perinatal asphyxia is the most common cause of neurologic injury and
neurodevelopmental delay. The signs of injury are nonspecific at birth, and
most indicators take hours to days before they become manifest. Early
recognition of the injury is important in guiding management during those
critical first days of life. Over a five-year period, we investigated 16
term neonates with a history of asphyxia on the first day of life who
demonstrated on intracranial Doppler sonography cerebral vessel high
diastolic flow with a resistive index below 60. Two infants died and one
was lost to follow-up. Three of the remaining 13 patients were normal at 8
months to 1 year follow-up. The remaining 10 patients had severe
neurodevelopmental delay with profound handicaps at follow-up periods from
3 months to 32 months. This study has confirmed earlier reports that in the
first days of life, a very low resistive index combined with history of
asphyxia is associated with an adverse outcome and may be considered one of
the earliest markers for poor neurodevelopmental outcome. Only 50% of these
patients demonstrated abnormal sonographic imaging.
