Predictive value of cerebral arterial Doppler ultrasonography in full-terminfants after perinatal asphyxia

Objective The aim of this study was to evaluate the role of cerebral arteri al Doppler ultrasonography in predicting adverse outcome of asphyxic term n ewborns. Methods Cerebral Doppler studies were performed in 25 term newborns with cl inical diagnosis of fetal distress, perinatal asphyxia or hypoxic-ischemic encephalopathy and 25 controls during the first 2 days of life and weekly t hereafter until discharge or death. Results Clinical diagnosis at admission and a grade-III hypoxic-ischemic en cephalopathy according to the Sarnat and Sarnat classification had sensitiv ities of 100% and 75%, specificities of 54.4% and 97.8%, and positive predi ctive values of 16% and 75%, respectively. Abnormal cerebral Doppler result s, defined as a resistance index less than or equal to 0.55, with a high en d-diastolic velocity, had occurred within 48 h of birth in four cases. Dopp ler examination predicted severe adverse outcome with sensitivity, specific ity and a positive predictive value of 100%. Conclusion In this study, cerebral Doppler ultrasound allowed an early and better appreciation of prognosis during the first 2 days of life of asphyxi c full-term newborns, contributing to a more adequate management of those i nfants in the neonatal intensive care unit.