Metabolism: Periventricular-Intraventricular Hemorrhage in Small Premature Infants

The incidence of periventricular-intraventricular hemorrhage (PVH/IVH) in small premature infants diagnosed by computerized tomographic scanning (CT) is 40–50%. Ultrasound brain scanning is now emerging as an alternative modality for diagnosing PVH/IVH as early as the first day of life. Portability of the equipment and lack of ionizing radiation make this method ideal for studying newborn infants in intensive care units. In the present study the diagnosis of PVH/IVH was made using CT and ultrasound. Infants with PVH/IVH were then compared with infants in whom no bleeding was detected. The relationship between selected obstetric, neonatal, asphyxia1 and therapeutic factors and PVH/IVH was studied in a group of small premature infants. Statistically significant associations with respiratory distress, ventilator therapy, low Apgar score and metabolic acidosis were observed, lending support to their role in the pathogenesis of PVH/IVH. The prognosis of small premature infants suffering from post-hemorrhagic hydrocephalus is probably related to the extent of the first insult and hemorrhage and the rate and extent of the development of subsequent hydrocephalus.