NICU - Scans and Tests

Before I go into more detail on this very fragile and scary subject, would like to say a few words: Number of scans depend on the situation of the baby. Some scans are part of standard investigations in the first week of life even if your baby is a term baby meaning she was born on time.

Information is power. Information helps questions asked become wiser and makes conversations with the doctors more meaningful. I am not sure if doctors agree to that:)

I am also giving you all the details for a reason. There are so many tests done and initial results usually require either close tracking or some sort of treatment. Each time you receive a result, it might be disappointing. Always keep in mind premature baby is completing its term outside your womb and all bodily systems are still in development.

Here is the list of scans and tests we went through:

• Brain scans in the 1st, 3rd and the 7th day post-delivery to understand the level of brain damage if there is any. We did have a grade 1 brain bleed, so brain scans were done regularly on the 15th, 28th and 42nd days to make sure it resolved. However, ours did not resolve completely until she was 5-6 months old. Our doctors were optimistic about it so we just had to be patient.

Scan is done through an ultrasound which is not an harmful procedure unlike MRI and CT.*

• Heart echo is done in the 1st, 3rd , 7th and 28th day post delivery. This is to observe any possible holes (PFO - opening between the upper chambers of the heart and PDA - opening between aorta and pulmonary artery) in the heart as your baby’s heart is not yet developed fully. We did follow up with her heart until she was 4 months old (that is when her PDA closed fully)

• Chest scan: Done in the 1st, 7th and 14th day to make sure lungs are fine. This can be repeated several times during NICU stay if your baby has some sort of heart defect or oxygen levels are off the chart.

Scan is done with an X-ray imaging tool, which spreads far less radiation than CT scan.*

• Blood Tests to check CRP levels, bilirubin levels, hemoglobin levels, hormones and many more indicators such as vitamins, minerals etc.

CRP indicates the level of infection in the body hence requires immediate antibiotic treatment to make sure infection does not damage the body and the brain. D.'s CRP level was not above the range, yet some was detected in the blood. She was put on antibiotics for a few days when she was born.

Bilirubin levels may indicate jaundice. Once bilirubin reaches a certain number, babies are put on phototherapy treatment. D., in her whole stay, got the treatment twice. One was in the first week and the second was in the third week (Yes, they keep checking it regularly to make sure all is in place)

Hemoglobin level may indicate anemia of prematurity which is very common among preemies, so we were told:) Even though regular blood test will tell you the correct levels, sometimes you can tell just by looking at your baby. Color of your baby tells a lot!

We went through anemia of prematurity. She was on iron supplement throughout her stay. Her hemoglobin levels kept going down so she received blood transfusion thrice.

• Newborn Screening Test: Screens for certain genetic problems. It is not your ordinary blood test. It was done in the first week of her stay which we were not aware of. It was then repeated on the 40th day as there was one outlier in the first test. That was when we found out such a test exists.

Outliers in the first time sometimes occur due to stress caused to your baby during delivery. That is why they repeat the test after a while to make sure there are no false outliers.

Ours came normal in the second one.

• Bone density test: Done to make sure your preemie’s bones are healthy. If there is any indicator off the charts, it is either supported with a supplement or closely tracked until it resolves. We checked off our indicators two months after we left NICU. We were on vitamin D supplement for a long time.

• Eye check: Done a couple of times during NICU stay. Retina of prematurity is one of the most common disorders among preemies and this test rules out any possible ROP. After the first test, we were advised to do a second one after a while. So we did and we got cleared:)

• Hearing check: Done close to discharge date. This was the first test, we got cleared in the first round:) This test is one of the discharge requirements.

Click to see discharge requirements