NeoNotes
Journal Club
Andrew
B. Kairalla MD, Editor
4-018 | Additional Comments | Previous Article | Next Article | Search | List of Articles | Submit Comments | Index | FSN Home Page
Highlights from the Southeastern Association of Neonatologists Meeting at Marco Island, May 15-18, 2003
Screening for IVH and PVL
Non-Invasive Cranial Imaging of the At-Risk Neonate. Presented by Lu-Ann Papile. University of New Mexico School of Medicine, Albuquerque, NM.
Editor’s Note: In 2001, a committee of prominent neonatologists, neurologists, perinatal epidemiologists, and neonatal radiologists was appointed to review the literature and make recommendations concerning the routine neuro-imaging of the at-risk neonate. Their findings were published as a practice parameter that was published in Neurology (2002); 58:1726-38. Dr. Papile participated on this committee, and summarized of their recommendations:
- Only infants < 30 weeks gestation should undergo routine screening for IVH or PVL.
- The initial brain ultrasound exam should not be done until 7-14 days (unless indicated for clinical reasons).
- A repeat cranial sonography should be done at 36-40 weeks (or just prior to discharge) to screen for periventricular leukomalacia (PVL).
- If the initial screening brain ultrasound (at 7-14 days) is normal or shows a grade 1 or grade 2 IVH, no further screening ultrasound exams need to be done prior to the exam at the time of discharge.
Comment: If adopted, these recommendations should result in far fewer screening cranial ultrasound exams in most of our nurseries. Unfortunately not many neonatologists read the neurology literature where these recommendations were published. It would be nice if the AAP perinatal section would formally endorse this practice parameter, and re-publish it in Pediatrics or the Journal of Perinatology. ABK
You may add your own comments to the discussion of this topic by selecting : Submit Comments.