Resistive index as an early prognostic marker in neonatal hypoxic-ischemic encephalopathy: a prospective observational study

Nutan R. Bhagora; Maulik Shah; Mamta Baloda; Sejal Borkhatariya

doi:10.18203/2349-3291.ijcp20250405

Authors

Nutan R. Bhagora Department of Paediatrics, Shri M. P. Shah Government Medical College and G. G. G. Hospital, Jamnagar, Gujarat, India
Maulik Shah Department of Paediatrics, Shri M. P. Shah Government Medical College and G. G. G. Hospital, Jamnagar, Gujarat, India
Mamta Baloda Department of Paediatrics, Shri M. P. Shah Government Medical College and G. G. G. Hospital, Jamnagar, Gujarat, India
Sejal Borkhatariya Department of Paediatrics, Shri M. P. Shah Government Medical College and G. G. G. Hospital, Jamnagar, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20250405

Keywords:

Cranial Doppler ultrasound, Hypoxic-ischemic encephalopathy, Neonatal prognosis, Resistive index

Abstract

Background: Hypoxic-ischemic encephalopathy (HIE) remains a leading cause of neonatal morbidity and mortality. The resistive index (RI), measured via cranial Doppler ultrasound, has emerged as a potential prognostic marker for early neurological outcomes. This study aims to assess the prognostic value of RI in neonates with HIE.

Methods: A prospective observational study was conducted on 110 neonates diagnosed with HIE at a Neonatal Intensive Care Unit (NICU) of Guru Gobindsingh Government Hospital, Jamnagar. RI was measured at 6 and 12 hours of life using Cranial Doppler ultrasound. Data on perinatal risk factors and clinical outcomes were collected. Neurological assessments were performed at 3 and 6 months. Standard statistical tests, including chi-square analysis, were used for data interpretation.

Results: A significant association was found between RI values at 6 hours and adverse neurological outcomes at 3 months (χ² = 11.45, p = 0.009) and at 6 months (χ² = 10.89, p = 0.012). Similar associations were observed for RI at 12 hours. Higher RI values correlated with increased mortality and adverse neurodevelopmental outcomes.

Conclusions: RI measurement via cranial Doppler ultrasound serves as a valuable early prognostic indicator in neonates with HIE. Routine incorporation of RI assessments in neonatal care protocols may aid in early risk stratification and targeted interventions to improve long-term outcomes.

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