ICNC Abstracts, ICNC 2018

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General Movement Assessment in High Risk Infants in Sri Lanka: Experience from a Large Tertiary Care Hospital
gemunu prabhath hewawitharana, Piyumi Sasikala Wickramarachchi, Ayesha Yaddehi, R.D. Susantha Kumara, K.V. Kanchana Nilukshika, K.M.I. Induli, D.R. Sadeepi Chathuranga, D.L.N. Priyangika, W.R.A. Shantha, Sajee Anuradha Gamage, Bimba D.R. Hewawitharana, Champa J Wijesinghe

Last modified: 2018-09-09

Abstract


Introduction: The Prechtl General Movement Assessment (GMA) is predictive of cerebral palsy (CP), however it has not been well studied in resource limited countries such as Sri Lanka.

Objective: Characterize the spectrum of movement abnormalities and predictive value of the GMA in high risk Sri Lankan infants.

Method:All high risk infants seen at Karapitiya Teaching Hospital from 01/01/2017 to 30/05/2018 underwent GMA before3 months gestational age by a certified Prechtl assessor using a standard video, blinded to clinical status.

Results:315 high risk infants(57% male) were assessed. Diagnoses included prematurity (65%), neonatal encephalopathy (14%), meningitis (18%) and seizures (22%). Of 270 neonates assessed in the writhing period before gestational age 40 weeks, 54% were normal,45% demonstrated poor repertoire (suggesting moderate risk for CP) and1 infant showed cramped synchronized movements (high risk for CP). 22% of 111 infants assessed in the fidgety period at 3 months of age had absent fidgety movements (higher risk for CP). These infants had the following risk factors: prematurity (64%), neonatal encephalopathy (34%), meningitis (16%), and seizures (36%). Of this group, 60% were ventilated >24 hours and 36% had an abnormal brain ultrasound. Chi square statistical analysis found no correlation between CP risk and any risk factor except ventilation> 24 hours (P-value =0.001).

Conclusion: Similar to reports from other countries, we found 8% of high risk infants were at high risk of developing CP, suggesting that the GMA is an appropriate screening tool in resource limited settings.

 


Keywords


General Movements Assessment , High Risk infants, Cerebral palsy

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