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

Objective The aim of this study was to evaluate the role of cerebral arterial Doppler ultrasonography in predicting adverse outcome of asphyxic term newborns. Methods Cerebral Doppler studies were performed in 25 term newborns with clinical diagnosis of fetal distress, perinatal asphyxia or hypoxic-ischemic encephalopathy and 25 controls during the first 2 days of life and weekly thereafter until discharge or death. Results Clinical diagnosis at admission and a grade-III hypoxic-ischemic encephalopathy according to the Sarnat and Sarnat classification had sensitivities of 100% and 75%, specificities of 54.4% and 97.8%, and positive predictive values of 16% and 75%, respectively. Abnormal cerebral Doppler results, defined as a resistance index less than or equal to 0.55, with a high end-diastolic velocity, had occurred within 48 h of birth in four cases. Doppler examination predicted severe adverse outcome with sensitivity, specificity 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 asphyxic full-term newborns, contributing to a more adequate management of those infants in the neonatal intensive care unit.