Introduction: Many antenatal, perinatal and post-natal factors predispose a child to develop cerebral palsy (CP). Perinatal asphyxia in term neonates and prematurity in preterm babies are the most common causes of CP. The advances in genetics have expanded our understanding of CP. Knowing the exact cause helps to counsel parents and plays an important role in prenatal counselling. Premature rupture of membranes (PROM) when prolonged (i.e., more than 12-24 hours), by causing chorioamnionitis and predisposing to perinatal asphyxia, is associated with CP. Association of PROM of less than 12 hours with CP is not clear. Methods: Retrospective review of charts of children with CP who had a normal birth history and whose genetic evaluation using whole exome sequencing (WES) was negative was done. Parents were interviewed in detail for presence of PROM. The clinical and neuroimaging features of these children was analysed. Results: We had four children fulfilling our study criteria. Age ranged from 2 to 5 years. All had cried after birth. None were admitted in NICU. Mothers reported PROM from 3 to 12 hours. Most presented mild mixed (spastic and dyskinetic) type of cerebral palsy. Neuroimaging showed paucity of white matter, thin corpus callosum, ventriculomegaly and rarely periventricular leukomalacia. Cognition was well preserved. Extensive work up like screening for IEMs. Follow up for 2-3 years did not show any progression/ worsening. Conclusion: PROM < 12 hours can predispose to mild cerebral palsy. These babies do not have history of NICU admission. MRI resembles genetic spastic paraplegia.

Mahesh Kamate
KAHER University's J N Medical College
India

Virupaxi Hattiholi
KAHER University's J N Medical College
India