Intraventricular hemorrhage. Incidence and outcome in a population of very-low-birth-weight infants
S. Hawgood, J. Spong and V. Y. Yu
The incidence, extent, and outcome of germinal matrix
hemorrhage-intraventricular hemorrhage (GMH-IVH) were determined with the
use of ultrasound and autopsy findings in 100 consecutive infants, with a
birth weight of less than 1,500 g. Serial ultrasound examinations once or
twice weekly were performed with the use of a portable real-time
linear-array scanner. The overall incidence of GMH-IVH was 46%. Twenty
infants had grade 1 (GMH), 24 had grade 2 (IVH +/- GMH), and two had grade
3 (IVH +/- GMH with intracerebral hemorrhage) conditions. The mortality in
infants with GMH-IVH was 35%, compared with 13% in infants without GMH-IVH.
Although 11 (37%) of 30 survivors with GMH-IVH had ventricular dilatation,
only two infants required ventriculoperitoneal shunts for progressive
hydrocephalus. The incidence of GMH-IVH was increased in outborn infants,
in those delivered vaginally, and in those who required mechanical
ventilation, bicarbonate therapy, or volume expansion in the first 24
hours. The long-term prognostic significance of the ultrasound findings was
unknown and will be determined by follow-up studies.
