Nomograms and Reference Ranges for Intra-Cranial Ventricular Dimensions in Indian Neonates

Objectives: To establish normal reference values for commonly used ventricular indices - Anterior Horn Width (AHW), Ventricular Index (VI) and Thalamo-Occipital Distance (TOD)-against common variables including gestational age, birth weight and head circumference in Indian newborns.

Methods: This was a cross-sectional study. Cranial ultrasound was performed between post-natal days 3 to 7. Anterior fontanelle was taken as the acoustic window. Data were analyzed to determine correlation, coefficient of determination (R2), regression equations and plotted against gestational age (GA).

Results: Total 2200 newborns were included in the study. The study observed that there is an increase in VI, AHW and TOD with an increase in gestational age (p-value < 0.001) and birth weight (p-value < 0.001). No significant correlation of gender and singleton or multiple gestation-with the intraventricular dimensions was observed (p-value > 0.05). All the three ventricular parameters were found to have a significantly lower mean value in the normal vaginal delivery group as compared to the LSCS group. There was a good correlation between ventricular indices of the left and right side. Nomograms of AHW, TOD, and VI were prepared with respect to gestational age.

Conclusions: Intracranial ventricular size dimensions vary significantly with increasing gestational age and birth weight. The new nomograms for various ventricular indices of Indian neonates can assist in objectively assessing ventricular sizes.