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The incidence, timing, and predisposing factors of germinal matrix and intraventricular hemorrhage (GMH/IVH) in preterm neonates
Authors:Hassan Kadri  Alhakam A Mawla  Jehad Kazah
Institution:(1) Division of Pediatric Neurosurgery, Department of Neurosurgery, Moassat University Hospital, P.O. Box 12183, Damascus, Syria;(2) Medical and Scientific Research Center, Damascus, Syria;(3) Neonate Intensive Care Unit, Children’s University Hospital, Damascus, Syria
Abstract:Background Germinal matrix and intraventricular hemorrhage (GMH/IVH) is a known complication occurring in the first week of life in preterm neonates. However, the precise time of its occurrence and the ideal time to perform diagnostic imaging studies remain controversial. The purpose of this paper is to address these two issues in our patient population to allocate our resources to those at highest risk.Materials and methods This study included 282 premature newborns (under 37 weeks of gestation) that were admitted to our neonate ICU in a year’s time and screened for GMH/IVH. They were grouped in four categories according to their weight at birth, and according to their gestational age. All patients had a daily cranial ultrasound during the first week. It was then repeated once in the second week and once in the third.Results We found that the incidence of GMH/IVH among preterm neonates was 44.68%. It was inversely related to the weight and the age of the newborn. The onset of bleeding coordinated with the occurrence of hypoxia and respiratory distress requiring mechanical ventilation. The majorities occurred in the first 7 days of life; they were mostly grade I and II according to the Papule classification and silent for the most part. Complications were present in 41% of the survivors.
Keywords:Germinal matrix and intraventricular hemorrhage  Hydrocephalus  Leucomalacia  Preterm
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