Original Research Article
Year: 2017 | Month: March | Volume: 7 | Issue: 3 | Pages: 27-31
Assessment of Intraventricular Haemorrhage in Preterm Neonates Using Neurosonography through Anterior Fontanelle
Dr. Vishwajit Patil1, Dr. Manisha Patil2, Dr. Sudhir Sarawade1, Dr. Sangita Kumbhojkar1, Dr. Suresh K V3
1Department of Pediatrics, RCSM Government Medical College, Kolhapur (District), Maharashtra (State).
2Assistant Professor, Department of Pediatrics, RCSM Government Medical College Kolhapur (District), Maharashtra (State), India.
3Faculty of Dentistry, SEGi University, No. 9 Jalan Teknologi, Taman Sains, Petaling Jaya, Kota Damansara, Selangor-47810, Malaysia.
Corresponding Author: Dr Suresh K V
ABSTRACT
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.
Key words: preterm, low birth weight, intraventricular hemorrhage, neurosonogram