124 Prevention of Hypoxic-Ischemic Cerebral Damage in Preterm Infants by Phenobarbital (original) (raw)
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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.
Pathophysiology and Management of Intraventricular Hemorrhage in Preterm Infants
EC Paediatrics, 2018
As more and more premature infants are surviving because of the better neonatal care and advanced technology, intraventricular hemorrhage remains an important cause of brain injury in extremely premature infants. Preventive measures to reduce the incidence have limitations because of unmodified risk factors like gestational age and anatomic immaturity. Various treatment modalities are attempted to limit the progression of ventricular dilation and hydrocephalus with limited success. Limitations of the ultrasound in detecting white matter and cerebellar lesions is a major concern for counseling the parents regarding the long-term outcome. Recent findings of adverse neurodevelopmental outcome even with minor grades of hemorrhages is a stimulus for future research for managing these cases. This article is the review of the etiopathogenesis, diagnosis, management and outcome of intraventricular hemorrhage in premature infants.
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.
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.
Early human development, 2018
Intraventricular hemorrhage (IVH) is one of the most serious complications in preterm infants and is associated with neurological sequelae and mortality. Over the past few decades, the rate of IVH has decreased due to improved neonatal intensive care. However, up to 15-25% of very and extremely premature infants (<32 and <28weeks of pregnancy (WOP) respectively) still suffer from IVH. The aim of this study was to perform an updated, multicenter analysis to identify ante-, peri, and postnatal factors other than gestational age/birth weight associated with IVH of any grade in a large cohort of very and extremely premature infants. We performed a retrospective analysis in a prospectively conducted multicenter cohort study between 01/01/1998-31/12/2012 at 5 level 3 perinatal centers. All relevant ante-, peri- and neonatal data were collected and univariate as well as multivariate logistic regression analysis was performed. 765 inborn infants with a gestational age<32 WOP were e...