Clinical Presentation of Preterm Neonates with Intraventricular Hemorrhage: Experience in a Tertiary Care Hospital in Dhaka (original) (raw)
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Child's Nervous System, 1999
The improvement in the survival rate of infants born at the limit of viability, i.e. <26 weeks of gestational age, raises concern about the risk of neurodevelopmental disabilities. The relevance of intraventricular hemorrhage (IVH), which is the most frequent cerebral lesion diagnosed in extremely low birth weight neonates, cannot then be underestimated. Pharmacological interventions designed to prevent the occurrence of IVH and its complica-tions have not been entirely conclusive. The understanding of pathogenetic factors involved in the genesis of IVH is the key to planning of new strategies and meanwhile of implementing care guidelines aimed at its prevention.
Nigerian Journal of Clinical Practice, 2019
Background: Intraventricular hemorrhage (IVH) is a severe complication among preterm neonates which can result in hydrocephalus, cerebral palsy, behavioural disorders, learning disabilities, or death. It is important to identify the factors associated with IVH in order to prevent these neurological consequences and reduce the resultant burden of neurological disease. Aim: To determine the factors associated with IVH among preterm neonates. Design: The study was prospective cross-sectional in design. Subjects and Methods: Ninety-nine preterm neonates who were < 37 completed weeks of gestation were recruited consecutively from the Special Care Baby Unit of a Tertiary Hospital. Transfontanelle ultrasonography was used to detect IVH and the factors associated with IVH were classified into: neonatal, maternal (prenatal), and clinical factors. Data were analyzed using SPSS version 16.0 for windows. Chi-squared test and Fisher's exact probability test were used as appropriate. The l...
Iranian Journal of Child Neurology, 2021
Objective Intra-ventricular hemorrhage (IVH) is the leading cause of mortality and disability in premature neonates. The present study aimed to determine the frequency of IVH and its risk factors in the premature newborns admitted to the Neonatal Intensive Care Unit (NICU)at Fatemieh Hospital in Hamadan, Iran, in 2016. Methods & Materials This retrospective cross-sectional study was conducted on178 neonates with a gestational age of ≤ 32 weeks admitted to Fatemieh Hospital affiliated to the Hamadan University of Medical Sciences, Hamadan, Iran, in 2016. The study population was selected using the census method. The newborns were subjected to cranial ultrasound on the seventh day of life, and they were assigned into two case and control groups (namely neonates with IVH and those without IVH, respectively). Intra- ventricular hemorrhage was classified into four grades regarding Papile classification. The patients’ demographic specifications, including 1- and 5-minute Apgar scores, typ...
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.3\_March2017/IJHSR\_Abstract.05.html, 2017
Background: Cerebral intraventricular haemorrhage (IVH) is the most common CNS lesion found in autopsy of newborn. It occurs almost exclusively in premature infants less than 2500 gm. About 90 % of IVH originate in subependymal germinal matrix. Modern and advanced neonatal care has reduced the mortality rate of preterm and extreme preterm neonates but if the incidence of IVH is not decreased, then the morbidity will increase in future and it will be a great psychological trauma to parents and society. It is important to regularly monitor IVH with neurosonography at regular intervals to prevent advancement of grade I hemorrhage to higher grades. Because grade III and IV hemorrhage has much worse prognosis than grade I hemorrhage. Also mortality is much higher with higher grades of hemorrhage. Aim: To assess the distribution of IVH and its risk factors using Neurosonography. Material & Methods: Present prospective study was conducted in preterm newborns admitted in Nicu having intraventricular haemorrhage (IVH). Study was conducted over period of 2 years. Study group comprised of 545 preterm neonates admitted who fulfilled inclusion criteria of study. Radiological assessment was done with serial USG through anterior fontanell (Neurosonography). Babies with clinical suspicion of IVH but normal Neurosonogram were subjected to C.T. Scan brain. Result: IVH was found in 10.8% (59 babies). Highest incidence (52.5%) was found between gestational age of 26-30 weeks. Majority of IVH babies i.e 38 (68.6%) had birth weight less than 1kg. Incidence of IVH in babies of mother who had not received antenatal steroids was 77.96%. Usg through anterior fontanelle could detect IVH in 100% of babies with IVH. Mortality rate was highest in grade 4 IVH & lowest in grade I IVH. Conclusion: IVH is more common in extreme preterm and ELBW babies. Antenatal steroids is found to be beneficial in decreasing incidence of IVH in preterm babies in this study. Mortality rate increases as grades of IVH increases. Nerosonography is very effective to detect even early grades of IVH.
Academic Journal of Pediatrics & Neonatology, 2016
Intraventricular hemorrhage (IVH) is one of the major complications in premature infants, and its management is quite challenging. This review article describes the pathophysiology, risk factors, and complications of IVH. Further, it explains the current diagnosis and treatment of IVH, along with the recent advances in its management. IVH can occur due to fragility of germinal matrix vasculature, impairment of cerebral auto-regulation, coagulation disorders, genetic factors, and oxygen toxicity. Cranial ultrasonography has been the gold standard for screening in newborns for detecting abnormalities like IVH. However, the need of the hour is diagnostic techniques which not only provide information on brain anatomy, but also related to the hemodynamics. Thus, various techniques are being explored like near infra-red spectroscopy (NIRS), advanced magnetic resonance imaging (MRI) techniques, along with the use of biomarkers. Regarding management of IVH, various invasive and non-invasive methods are used for managing intracranial pressure, respiratory distress, and avoiding complications like bleeding. Nowadays, various bundles of measures are being adopted to decrease the incidence of IVH like delayed cord clamping, minimal handling for first few hours, avoiding head down position, antenatal corticosteroids etc. Establishing standard diagnostic and management practices for IVH can prove to be really helpful in its management and prevention.
Intraventricular haemorrhage-timing of occurrence and relationship to perinatal events
BJOG: An International Journal of Obstetrics and Gynaecology, 1984
A total of 150 infants born at or before 34 weeks gestation had serial cranial ultrasound scans at age 8, 16, 24, 36, 4 8 h and I week. The overall incidence of IVH was 26%, but for infants < 1500 g it was 5 1% and 50% of all haemorrhages were first detected in the first 8 h of life. Lowoutlet forceps delivery and caesarean section offered some protection, but umbilical cord blood gas analysis did not support the hypothesis that hypoxia was causal. Respiratory distress and its complications were significantly associated with IVH. The more severe haemorrhages occurred in the less mature infants. The overall mortality in the study was 2796 for the JVH group and 1.8% for the non-IVH group.
Ultrasonographic pattern of intraventricular hemorrhage in preterm neonates in Lagos, Nigeria
2016
Intraventricular hemorrhage (IVH) commonly occurs in preterm neonates. Transfontanelle ultrasonography (TFUSS) is a non-invasive technique for the detection and characterization of IVH in preterm. The aim of this study was to determine the incidence, grades, time of evolution of IVH and to correlate the findings with demographics. Serial Transfontanelle sonography was performed on three hundred preterm neonates admitted into a tertiary hospital. Sonographic findings, relevant antenatal, perinatal, and postnatal history were obtained, with relevant tests of statistical significance. Ninety-five neonates (31.7%) had IVH, 90.5% of hemorrhages occurred in the first week of life. Incidence of IVH was higher in babies born at gestational age less than 32weeks and birth weight < 1.5kg. There was no statistical correlation between grades of IVH and the degree of prematurity. The incidence of IVH in preterm neonates is high therefore all preterm neonates should be serially scanned. The lo...
Intra-Ventricular Hemorrhage: Frequency and outcomes at the time of discharge
Caspian Journal of Pediatrics (CJP), 2022
Background and Objective: The aim of this study was to assess the frequency of Intraventricular hemorrhage (IVH) and its severity as an important cause of death and lifelong neurological complications in premature infants. Methods: This cross-sectional study was conducted in an academic referral hospital, designed for high-risk pregnancies over the period between Jan 2011 and Mar 2018. All premature (<34wk) and very low birth weight (<1500gr) infants diagnosed with IVH by brain ultrasonography (BUS) were included in the study. All infants’ information and outcome at the time of discharge were recorded and then analyzed. Findings: Out of 2563 eligible infants admitted to the neonatal intensive care unit, 138 neonates (5.38%) were diagnosed with IVH. The mean gestational age and the birth weights were 29.97±2.89 weeks and 1084±327.71 grams, respectively. The frequencies of IVH grades included: 106(76.81%) with grade I, 23(16.67%) with grade II, 7(5.07%) with grade III, and 2(1.45%) with grade IV. Four cases (2.9%) underwent ventriculoperitoneal shunt insertion and three of them died. Conclusion: In this study IVH frequency in our setting was lower, compared to that of developed countries. This may be due to limitation of performing BUS in neonates who died during the first week of life. Due to neurological complications, especially in severe cases of IVH, premature delivery and very low birth weight should be prevented with appropriate measures.
Frequency of Intraventricular Haemorrhage in Preterm Neonates
Background: Intraventricular hemorrhage is one of the most common problems of premature Infants. Its causes severe neurological morbidity and mortality. Objective: To determine the frequency of IVH in clinically suspected premature neonates in pediatric unit Jinnah hospital Lahore. Study Design: Hospital based cross sectional study. Setting: Pediatric department, Jinnah Hospital Lahore. Duration of Study: 17 th March 2007to17 th March 2008. Sample Size: 100 preterm neonates were included in study.
Intraventricular haemorrhage and haemostasis defects
Archives of Disease in Childhood, 1984
Twenty five of 106 preterm infants of 34 weeks' gestation or less developed intraventricular haemorrhage within the first 48 hours of life. A comparison of infants with and without intraventricular haemorrhage showed no significant differences in their haemostatic parameters at birth. At age 48 hours the group with intraventricular haemorrhage showed a prolonged activated partial thromboplastin time and reduced factor II, VII, and X activity. There was a significant correlation between the severity of intraventricular haemorrhage and the degree of haemostasis abnormality both in cord blood and in blood obtained at age 48 hours. Those infants sustaining grade IV intraventricular haemorrhage had a significantly prolonged activated partial thromboplastin time, reduced factor II, VII, and X activity; and a decreased fibrinogen concentration at birth. At age 48 hours these defects were accompanied by reduced platelet counts and an increased megathrombocyte index. Although intraventricular haemorrhage is multifactorial, we postulate that correction of haemostasis abnormalities at birth may prevent progression to more severe grades of haemorrhage. Detection of intracranial haemorrhages. Intraventricular and periventricular haemorrhages were detected using a Diasonics 20S ultrasound detector (Diasonics, Canada) fitted with a 7-5 mHz transducer. Serial craniosonograms were performed at 8 hour intervals in the first 24 hours of life, at 12 hour intervals in the second 24 hours, and weekly thereafter. Haemorrhages were graded according to 444