Detection of Neurological Complications by Cranial Ultrasound in Neonatal Sepsis: A Cross-sectional Study: Neurological Complications of Neonatal Sepsis

Nadia Hossain; Rumman Rumman; Mohammad Sazzaddul Alam; Alpana Jahan; Rajib Mahmud; Samrat Parajuli; Mohammod Shahidullah; Abdul Mannan

doi:10.4274/jpea.2024.322

Authors

Nadia Hossain Manikganj Medical College Hospital, Department of Neonatology, Manikganj, Bangladesh https://orcid.org/0009-0006-8374-3118
Rumman Rumman Rajshahi Medical College, Department of Neonatology, Rajshahi, Bangladesh https://orcid.org/0009-0001-6915-4097
Mohammad Sazzaddul Alam Chattogram Medical College Hospital, Department of Neonatology, Chattogram, Bangladesh https://orcid.org/0009-0006-0722-2679
Alpana Jahan Dr. Mr. Khan Shishu Hospital and Institute of Child Health, Dhaka, Bangladesh
Rajib Mahmud National Institute of Traumatology and Orthopaedic Rehabilitation, Department of Orthopaedic Surgery, Dhaka, Bangladesh https://orcid.org/0009-0008-3901-4203
Samrat Parajuli Lumbini Hospital and Technical College, Department of Orthopaedic Surgery, Butwal, Nepal https://orcid.org/0000-0002-3301-2126
Mohammod Shahidullah Bangabandhu Sheikh Mujib Medical University, Department of Neonatology, Shahbagh, Dhaka, Bangadesh https://orcid.org/0000-0002-8549-4964
Abdul Mannan Bangabandhu Sheikh Mujib Medical University, Department of Neonatology, Shahbagh, Dhaka, Bangadesh https://orcid.org/0000-0002-4546-7216

DOI:

https://doi.org/10.4274/jpea.2024.322

Keywords:

Neonatal sepsis, cranial ultrasound, neurological complications

Abstract

Neonates with sepsis are at risk of neurological complications. Cranial ultrasound (CUS) has been widely used in neonates for early detection of these intra-cranial abnormalities. It is a convenient, non-invasive, safe with no radiation exposure and quick imaging technique to visualize the neonatal brain parenchyma and ventricular system. To detect neurological complications in neonates with sepsis by CUS. This cross-sectional study was conducted in Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from June 2019 to September 2020. Inborn neonates with sepsis and inborn preterm neonates without sepsis satisfying the inclusion and exclusion criteria who were admitted into neonatal intensive care unit (NICU), BSMMU during study period were the study population. Among 110 neonates, 75 neonates with sepsis and 35 pre-term neonates without sepsis were assessed for eligibility. Among these 75 septic neonates 19 were excluded. Finally,56 septic neonates were analyzed. Out of them 21 (37.5%) neonates had abnormal neurological findings in CUS. Distribution of abnormal CUS findings were intraventricular hemorrhage (33%), features of meningitis (24%), hydrocephalus (14%), prominent lateral and third ventricles (10%), intracerebral hemorrhage (5%), features of ventriculitis (5%). Among 35 non-septic pre-term neonates, 5 were excluded due to guardians did not give consent to perform CUS. So, 30 non-septic pre-term neonates were analyzed, among them, 2 neonates (7%) had feature of intraventricular hemorrhage in CUS. Septic neonates with abnormal CUS findings, most of the neonates were male (71%), gestational age (34.57±3.043) weeks and birth weight (1985.2±684.132) gm. In babies with abnormal CUS, convulsion was significantly associated (p value 0.01). This study showed proven sepsis was significantly associated with abnormal CUS findings. The abnormal CUS findings in newborn with sepsis was 37.5%. So CUS may be an important investigatory modality in NICU for early detection of intracranial complications.