Background Cranial ultrasound scans (CUSS) are widely used to identify babies at later risk of serious disability. There is no consensus for the timing and frequency of routine CUSS providing the best prognostic correlation.

Objective To determine the routine CUSS practice in tertiary neonatal units.

Methods Telephone survey of all tertiary neonatal units (BAPM) in England using a structured questionnaire.

Results We surveyed 47 tertiary units with 100% response. CUSS was routinely done on all admitted babies in 2 units. The other 45 units had a gestation cut-off range from <29 to <35 weeks, 76% having a gestation cut-off of <32 weeks. 18 units had additional weight cut-off ranging from <1 kg to <1.8 kg. All units carried out at least one CUSS within the first week, 68% aiming for a first scan within 24 h from birth. 33 units (70%) performed more than 1 routine scan in the first week (median: 3 scans). Seven units did weekly scans on selected babies and four units did CUSS within the first week and at 6 weeks only. Routine scans were done by neonatal staff (60%), radiology staff (34%) or both (6%).

Conclusion There is wide variation in routine CUSS practice among tertiary neonatal units. Given the lack of evidence that multiple serial CUSS improve the predictive ability for serious disability compared to a single late CUSS, there is an urgent need to develop a uniform guideline for routine CUSS in neonatal units.