Aim: Cranial ultrasound is seldom used in middle-income countries, and the burden of
preterm brain injury and its relationship to perinatal data is unknown. We assessed cranial
ultrasound abnormalities in very low-birthweight (VLBW) infants and correlated the findings
with perinatal data.
Methods: VLBW Armenian infants receiving neonatal intensive care in 2012 were scanned
from birth to term-equivalent age (TEA). Clinical data were collected prospectively.
Results: We studied 100 VLBW infants with a median gestation of 30 weeks.
Periventricular white matter echogenicity (PVE) lasting more than two weeks was seen in
34 infants, grade III intraventricular haemorrhage (IVH) in 10, haemorrhagic parenchymal
infarction (HPI) in seven and cystic periventricular leukomalacia in two. Caudothalamic
notch echogenicity appeared in 36 infants after two to three weeks, with cystic
transformation in 22. At TEA, 17 infants had persisting PVEs and 55 had increased basal
ganglia/thalamic (BGT) echogenicity. Lack of antenatal steroids was significantly associated
with IVH and HPI and intubation at birth with IVH. Late BGT echogenicity was generally
seen in infants without perinatal problems.
Conclusion: Our study demonstrated that cranial ultrasound can be used effectively in a
middle-income country to identify high-risk infants and monitor quality of care.