Neonatal craniocerebral ultrasonographic features in pregnancy with maternal hypertensive disorder

Objective To analyze the characteristics of craniocerebral ultrasonographic images in neonates with maternal hypertensive disorder complicating pregnancy, and to discuss the changes of craniocerebral injury and cerebral hemodynamics. Methods From October 2015 to August 2017, 156 newborns admitted by neonatal intensive care unit of Beijing Luhe Hospital were selected for craniocerebral screening. The study group included 81 cases of neonates with gestational hypertension, and 75 neonates with no high-risk perinatal factors were enrolled as the control group. Craniocerebral ultrasound imaging was performed to analyze the perinatal data, craniocerebral injury and cerebral hemodynamics in two groups of newborns. Results The neonatal mass of the study group was (2769.62±657.76) g, significantly lower than (3 423.1±521.8) g of the control group (t=6.623, P<0.001). The maternal gestational weeks of the study group were (36.43±1.99) weeks, and the premature rate was 61.7% (50/81), while in the control group they were (39.02±1.12) weeks and 0% (0/75). The differences were statistically significant (Z=-7.311, P<0.01; χ2=68.134, P<0.001). The results of ultrasound examination showed that the incidence of craniocerebral injury, the blood flow resistance index (RI) value of anterior cerebral artery (ACA) and bilateral middle cerebral artery (MCA) in the study group were significantly higher than those of the control group with statistically significant differences (χ2=14.956, t=-5.798, -4.099, -3.943; all P<0.001). Neonatal craniocerebral injury and hemodynamic changes were positively correlated with maternal gestational hypertension (rACA, rleftMCA, rrightMCA=0.461, 0.296, 0.305; all P<0.001). Conclusions Craniocerebral ultrasonography is the first choice in dynamic monitoring of neonatal craniocerebral abnormalities. The RI values of ACA and MCA can be used to evaluate the influence of hypertensive disease in pregnancy on newborn, and can accurately reflect the changes of blood flow in the neonatal brain, which provide the basis for the early diagnosis and treatment of neonates with hypertensive diseases during pregnancy. Key words: Gestational hypertension; Ultrasonography, Doppler; Intensive care, Neonate; Craniocerebrum