Diagnostic Value of Magnetic Resonance Imaging in Fetal Lateral Ventriculomegaly and the Relationship Between the Degree of Isolated Lateral Ventriculomegaly and Neonatal Prognosis

Objective::To assess the value of magnetic resonance imaging(MRI)in fetal lateral ventriculomegaly diagnosed with ultrasound,and to study the relationship between the degree of isolated lateral ventriculomegaly and neonatal prognosis.Methods::The pregnancy information and outcomes of 97 cases of fetal ventriculomegaly were retrospectively reviewed in the Tianjin Central Hospital of Gynecology Obstetrics from January 2016 to December 2017.The maternal age was 18-42 years,and the fetal gestational age at diagnosis was 19+4 to 37+3 weeks.MRI and ultrasound were used to compared the diagnosis of fetal lateral ventriculomegaly and evaluated the development of the nervous system after birth.Results::Among 97 pregnancy cases,associated central nervous system malformations were observed in 36 cases on ultrasound or ultrasound+MRI.Central nervous system malformations were diagnosed with ultrasound in 15 cases(15/36,41.7%)and with ultrasound+MRI in 25 cases(25/36,69.4%).Pearsonχ2 test was used to compare the detection rates between the groups,and the difference was statistically significant(P<0.05).We followed up 61 cases of isolated lateral ventriculomegaly for 1-3 years after birth.According to the width of the lateral ventricle of the fetus in middle pregnancy,the subjects were grouped as follows:mild 33 cases(lateral ventricle width 10.0-12.0 mm),moderate 23 cases(lateral ventricle width 12.1-15.0 mm),and severe 5 cases(lateral ventricle width>15.0 mm).The rate of normal growth and development in the mild group was 90.9%(30/33),that in the moderate group was 69.6%(16/23),and that in the severe group was 40.0%(2/5),and the difference between groups was statistically significant(P<0.05).Conclusion::Ultrasound combined with MRI can detect more central nervous system malformations,and the degree of isolated lateral ventriculomegaly is closely related to fetal prognosis.

Effect of erythropoietin combined with hypothermia on serum tau protein levels and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy

Although hypothermia therapy is effective to treat neonatal hypoxic-ischemic encephalopathy,many neonatal patients die or suffer from severe neurological dysfunction.Erythropoietin is considered one of the most promising neuroprotective agents.We hypothesized that erythropoietin combined with hypothermia will improve efficacy of neonatal hypoxic-ischemic encephalopathy treatment.In this study,41 neonates with moderate/severe hypoxic-ischemic encephalopathy were randomly divided into a control group（hypothermia alone for 72 hours,n = 20） and erythropoietin group（hypothermia ＋ erythropoietin 200 IU/kg for 10 days,n = 21）.Our results show that compared with the control group,serum tau protein levels were lower and neonatal behavioral neurological assessment scores higher in the erythropoietin group at 8 and 12 days.However,neurodevelopmental outcome was similar between the two groups at 9 months of age.These findings suggest that erythropoietin combined with hypothermia reduces serum tau protein levels and improves neonatal behavioral neurology outcome but does not affect long-term neurodevelopmental outcome.

PROGNOSTIC VALUE OF ELECTROENCEPHALO-GRAPHY BACKGROUND ACTIVITIES IN ASPHYXIATED NEONATES

Objective To identify the changes in the electroencephalography (EEG) background activities in asphyxiated neonates and to determine the prognostic value of these changes in neurological outcomes.Methods A total of 46 asphyxiated neonates and 31 healthy newborns were studied using standard EEG.Forty-three neonates from the asphyxiated group were followed up and had neurological examinations and developmental assessments at 3,6,9 and 12 months of age.The parameters that had prognostic significance were statistically analyzed,and the correlations of these parameters with neurological outcome were estimated.Results ①Significant EEG changes were found in asphyxiated neonates:a longer maximum duration of interburst interval,lower amplitudes during all states,and a higher incidence of brief burst and sleep-wake cycle disturbance.②There were significant correlations between hypoxic-ischemic encephalopathy (HIE) classification,debased amplitude,positive spikes and sharp waves,and abnormal sleep cycles.③Gestational age,birth weight,EEG amplitude,severity of HIE,occurrence of sleep-wake cycle disturbance,and imaging abnormality were found to be important markers for predicting the outcome of neonates with asphyxia.Conclusion The study suggested that changes in the EEG background activities correlated with the prognosis of neonates with asphyxia.EEG is an effective tool for predicting the neurologic outcome of asphyxiated newborns.