title: Do normal head ultrasounds need repeating in infants less than 30 weeks gestation?
abstract: OBJECTIVE
  Current head ultrasound (HUS) screening recommendations in preterm infants often include a repeat HUS, regardless of initial findings. The objective of this study is to determine the rate of subsequent severe intraventricular hemorrhage (IVH), ventriculomegaly (VM), or periventricular leukomalacia (PVL) among infants < 30 weeks gestation (EGA) with a normal HUS at day of life (DOL) 4-10.
  
  
  METHODS
  Retrospectively collected data were analyzed for all infants < 30 weeks EGA cared for in one NICU from 1 January 2010 to 31 August 2014. Infants with severe congenital anomalies were excluded. We reviewed the first three HUSs and last documented HUS. Severe IVH was defined as > Papile grade 2 and significant interval HUS change was defined as development of severe IVH, PVL, or VM.
  
  
  RESULTS
  Of the 383 infants who had an initial screening HUS between DOL 4 and 10, 258 (67%) were initially normal and repeat screening was performed in 228 of these. None developed severe IVH on follow-up HUS. One infant developed VM secondary to GBS meningitis, and one developed echogenicity concerning for PVL that later resolved.
  
  
  CONCLUSIONS
  Among very preterm infants with a normal HUS between DOL 4 and 10, routine follow-up HUS is unlikely to identify a significant change.
authors.affiliation: a Department of Pediatrics and.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Kaeppler
authors.affiliation: a Department of Pediatrics and.
authors.forename: Nora
authors.initials: N
authors.lastname: Switchenko
authors.affiliation: a Department of Pediatrics and.|b Division of Neonatology , University of Utah School of Medicine , Salt Lake City , UT , USA.
authors.forename: Robert
authors.initials: R
authors.lastname: DiGeronimo
authors.affiliation: a Department of Pediatrics and.|b Division of Neonatology , University of Utah School of Medicine , Salt Lake City , UT , USA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Yoder
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012189:Retrospective Studies
keywords: Head ultrasound; intraventricular hemorrhage; preterm infant; screening