الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
NS accounts for one third of the annual neonatal deaths around the world, which is estimated to be around a million per year. 99% of NS occurs in developing countries, due to poor perinatal infection control practice, making it a huge burden. Some literatures said that through the process of neonatal sepsis, there is a change in the CBF, which in return may have a role in perinatal brain damage, both short- and long-term morbidity. Therefore, knowing the effect of NS on the CBF, is important to allow more appropriate medical intervention, to favorably alter the clinical outcome. TCD is a fast, easy, feasible, safe and bed side tool, which can be used to assess the changes in the CBF and for follow up together with transcranial US for detection of complications. There-fore, the aim of the present study was to determine CBF changes by US Doppler examination in neonatal sepsis This study was conducted in the NICU of Tanta university hospital during the period from February2021 to December 2021. It was carried out on two groups: • group (I): thirty-two (32) neonates with NS diagnosed by clinical and laboratory data (Sepsis group). • group (II): twenty-eight (28) healthy neonates matched in GA and sex and were referred as (Control group). All of them were full term more than 37 weeks, BW ≥2500 gm. • The ACA was insonated using the trans-fontanellar approach; the probe was placed on the anterior fontanel in a longitudinal position (sagittal position). When the corpus callosum was observed, color Doppler was applied, the ACA is the branch of the ICA which continues with it and coarse around the corpus callosum. The MCA was insonated using a trans-temporal approach; the probe was placed on the temporal aspect of the head, cephalic to the zygomatic arch and immediately anterior and slightly superior to the tragus of the ear in a transverse position. When the midbrain was observed, color Doppler was applied and the circles of Willis became evident, the MCA is the ICA branch that was not sharing in it and directed laterally into the Sylvain fissure. The present study revealed the followings: There were no significant differences, as regards age, sex, GA and mode of delivery, but significant decrease in BW in the sepsis group as compared with the control group. As regards the clinical presentation of the sepsis group on admission, it was found that, the hypo-activity and poor suckling were the most common presentation followed by respiratory distress, while convulsion was the least common presentation in sepsis group. In the present study TCD evaluation of the MCA and ACA among sepsis and control groups, showed statistically significant increase in both PSV and EDV, but statistically significant decrease in the RI, PI among sepsis group as compared to control non-sepsis group. • Among all the parameters studied in MCA, and ACA the sensitivity of PI was highest in the present study with sensitivity of 97%, 97% and specificity of 82 %, 89% and AUC was 0.936, 0.992 respectively.