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Imaging reveals intracranial bleeding in asymptomatic newborns

Feb 2007
A recent neonatal brain development study led by Dr. John H. Gilmore of the University of North Carolina School of Medicine at Chapel Hill used MRI to assess intracranial hemorrhage in 88 babies between 1 and 5 weeks of age, delivered vaginally or via cesarean section. Previous studies have correlated the bleeding to factors such as assisted vaginal delivery and prolonged labor, but few have retrospectively evaluated the condition’s connection to obstetric and neonatal risk factors, especially in asymptomatic newborns.

With a 3-T MRI machine, the researchers obtained images of the 44 boys and 44 girls chosen for investigation. An experienced neuroradiologist blind to neonatal and obstetric data reviewed the images for subdural, subarachnoid and intraparenchymal hemorrhages. The researchers collected data on duration of labor and maternal birth trauma as well as on neonatal parameters.

Researchers observed intracranial bleeding only in babies delivered vaginally. Sagittal and transverse MRIs of a newborn reveal intraparenchymal hemorrhage in the temporal lobe (indicated with white arrows). Images reprinted with permission of Radiology.

They observed intracranial bleeding in 17 babies, all of whom had been delivered vaginally. Seven of the infants showed evidence of two or more of the hemorrhage types screened. Final calculations demonstrated that 26 percent of vaginal births had resulted in at least one type of the condition.

On the basis of their data, the researchers found that intracranial bleeding was associated with neither assisted delivery nor lacerations in the woman’s genital region. Nor were those newborns with hemorrhages more likely to show visible evidence of birth trauma. These and other results from the study were published in the Dec. 19 online issue of Radiology.

Although this research makes the unexpected revelation that asymptomatic vaginally delivered babies have intracranial bleeding in more than one in four cases, other studies will have to determine the link between the seemingly asymptomatic hemorrhages and subsequent neurocognitive development.

The study of radioactive substances and high-energy radiations such as x-rays and g-rays.
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