Optimising the use of cranial ultrasound to screen for preterm brain injury

Preterm neonates are vulnerable to haemorrhagic and ischaemic brain injury, often without clinical signs. Cranial ultrasound is the primary screening tool, yet protocols vary widely. This thesis evaluated optimal screening timing in infants born before 32 weeks’ gestational using a systematic review and retrospective and prospective studies. Early screening in the first postnatal week was unnecessary for low-risk infants, whereas imaging at term-equivalent age detected additional injuries. Comparisons with magnetic resonance imaging highlighted modality differences. These findings support a tiered, risk-based approach to cranial ultrasound screening to strengthen evidence-based neonatal imaging practice.