title: Preterm screening by transfontanelar ultrasound - results of a 5 years cohort study.
abstract: OBJECTIVE
  Intracranial hemorrhages (ICH) might be the cause of significant psycho-motor or cognitive impairment in preterm babies. A 5 year cohort study performed in the IOMC was aimed  at  determining the prevalence and proportion of the main types of ICH diagnosed by transfontanelar (TF) ultrasound among admitted preterms, along with the neuro-developmental effects on a  12 month follow-up period.
  
  
  METHODS
  In the above mentioned period all enrolled newborns were examined by TF ultrasound according to a common standardized protocol. The 4 grade Papile ICH classification was used for all examined subjects. In order to determine the potential neurological sequels we performed a 12 month neurological follow-up of all 292 patients in the study group.
  
  
  RESULTS
  The prevalence of all types ICH diagnosed by systematic TF ultrasound was 20.4 %. The most prevalent type of ICH was peri-intraventricular: 40% grade I and  33 % grade II, with no major neurological sequels For both the correlation to the neurological outcome was statistically significant (p < 0.05). Severe neurological sequels were associated with grade III and IV, but the correlation was found to be statistically significant (p < 0.05) only for grade IV hemorrhages. A severe neurological outcome was of statistical significance only for the cerebellar hemorrhage outcome, although a similar pattern was also observed for the thalamic hemorrhages.
  
  
  CONCLUSIONS
  Systematic TF screenings for preterm is useful for early diagnosis and staging which might improve the management of rehabilitation therapies, and provide appropriate information on the disease outcome as well as influencing the quality of parental counseling.
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Pediatric Department Prof Dr A. Rusescu, Bucharest, Romania.
authors.forename: Florin
authors.initials: F
authors.lastname: Brezan
authors.forename: Mirela
authors.initials: M
authors.lastname: Ritivoiu
authors.forename: Amalia
authors.initials: A
authors.lastname: Drăgan
authors.forename: Ioana
authors.initials: I
authors.lastname: Codreanu
authors.forename: Diana
authors.initials: D
authors.lastname: Răducanu
authors.forename: Diana
authors.initials: D
authors.lastname: Feier
authors.forename: Ioana Alina
authors.initials: IA
authors.lastname: Anca
mesh_terms: D015331:Cohort Studies; D055762:Cranial Fontanelles / Q000000981:diagnostic imaging*; D002658:Developmental Disabilities / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D020300:Intracranial Hemorrhages / Q000175:diagnosis*; D008297:Male; D009460:Neurologic Examination; D012720:Severity of Illness Index; D014463:Ultrasonography