Predictive Value of Anterior Cerebralartery Spectral Doppler in Term Neonates With Hypoxic-Ischemic Encephalopathy

Hypoxic-ischemic encephalopathy (HIE) is a serious neurological condition with significant long-term neurological impairments and neonatal mortality, as a complication to perinatal hypoxic/ischemic insult. The predictive value of cranial ultrasound with spectral doppler of anterior cerebral artery (ACA), which supplies key areas of the frontal and medial brain regions remains rather underexplored, is hence being evaluated. Materials and significant findings: A prospective study was conducted for a period of 10 months which included 30 term neonates with perinatal hypoxia, low APGAR score at 1 and 5 minutes and/or clinically diagnosed HIE requiring NICU admission. These were compared with 40 healthy term requiring NICU admissions for reasons other than HIE. ACA Doppler indices were calculated and analysed. Correlation analysis revealed significant relationships between HIE severity and ACAparameters: positive correlation with PSV and EDV and negative correlations with PI, and RI. ACARI was the most promising index in distinguishing between different severities of HIE. EDV and PI mainly distinguish controls from HIE and highlight the difference between mild and severe groups. PSV is the least discriminatory doppler parameter. Conclusion: Cranial Doppler as an adjunct to B-mode imaging allows clinicians to monitor cerebral blood flow velocity and resistance indices, offering valuable information on cerebral perfusion and hemodynamics.