Early cranial ultrasonographic findings of neonates born from mothers with premature rupture of membranes

INTRODUCTION: Premature rupture of membranes (PROM) has maternal, fetal, and neonatal implications. PROM can cause intrauterine infection and preterm birth. Maternal infection/chorioamnionitis is associated with neonatal neurodevelopment, cerebral palsy, and periventricular leucomalacia. In our study, we aimed to find out the rate of PROM associated-histologic chorioamnionitis (HCA) and corioamnionitis associated early neonatal brain damage findings with cranial USG.
METHODS: One hundred and fifteen neonates born in Zeynep Kamil Maternity and Children Hospital were enrolled to the study. Neonates were divided into four groups according to gestational age (term/preterm) and duration of PROM (>24 h). Data about route of delivery, birth weight, gender, and APGAR scores were collected and placentas were examined histopathologically. All neonates were evaluated with cranial USG by a radiologist unannounced of neonatal clinical condition and placental pathology. Term-preterm neonates, preterm PROM (+) and PROM (–) neonates and term PROM (+) and PROM (–) neonates were compared with each other.
RESULTS: Total 115 neonates (52 female and 63 male), 50 term (mean: 39 GW) and 65 preterm (mean: 33.8±1.3 GW) neonates were enrolled to the study. Duration from PROM to birth was 2.2±2.7days in term group and 4.8±4.3 days in preterm group (p=0.014). APGAR scores of preterm neonates were lower than term neonates (p<0.01). There was no difference of placental examination results, timing of cranial USG examination and USG findings between term and preterm neonates (p>0.05). HCA rate was 30% in term and 26.2% in preterm group (p=0.648). Time of cranial USG imaging was 11.9±10.4 days in term and 9.1±7.7 days in preterm group (p=0.096). Four neonates (6.2%) in preterm PROM (–) group had abnormal cranial USG findings.
DISCUSSION AND CONCLUSION: In our study, we cannot show early neonatal brain injury pathologic findings associated with HCA using cranial USG. Abnormal cranial USG findings in preterm group are due to prematurity independent of chorioamnionitis and PROM.