CLINICAL PROFILE AND SHORT TERM OUTCOME OF INTRA VENTRICULAR HEMORRHAGE IN NEONATES BORN BEFORE 34 WEEKS OF GESTATION ADMITTED TO NEONATAL INTENSIVE CARE UNIT

Dr.Asha; Dr.Kamalrathnam

Volume : VII, Issue : VI, June - 2018

CLINICAL PROFILE AND SHORT TERM OUTCOME OF INTRA VENTRICULAR HEMORRHAGE IN NEONATES BORN BEFORE 34 WEEKS OF GESTATION ADMITTED TO NEONATAL INTENSIVE CARE UNIT

Dr. Asha, Dr. Kamalrathnam

Abstract :

INTRODUCTION:

Intraventricular hemorrhage (IVH) affects 15–20 % of babies born before 32 weeks of pregnancy. A lot of risk factors of developing IVH are known. The making appropriate recommendations for dealing with infant born less than 32weeks of gestation aimed at reducing the incidence of IVH is still needed. The study aim was to determine the incidence and analyze risk factors of IVH stage 3 and 4 in infants born before 34+0 weeks of pregnancy.

METHODS:

The retrospective analysis of 297 preterm babies (24 to 34 weeks of gestation) hospitalized in June 2016 to June 2017 at Department of Neonatology,institute of obstetrics and gynecology was performed. The diagnosis of IVH was confirmed by ultrasound scans according to Papille criteria. Stage 3 and 4 of IVH was confirmed in 38 (68 %) newborns from less than 28 weeks of gestation; 18(32%) from 28 to 32 weeks of gestation; and no babies above 32 weeks of gestation.

RESULT:

The incidence of IVH stage 3 and 4 was higher in children with incomplete 53(95%) use of AST (p<0.01), born with asphyxia 42(74%) (p<0.01), with shock treated with NS bolus 54(96%) (p<0.01) andinotropes54 (96%) (p<0.01) and those neonates treated for hypotension 54(96%) (p<0.01).N the logistic regression analysis considering the entire group, we found that gestational age (β = − 0.414; p = 0.000),birthweight (β = 0.991; p = 0.000) and 5min Apgar score (β = 0.322; p = 0.004) after adjusting for birth weight were associated with both grades of IVH (R 2 = –0.9709; p < 0.0001 for the model). fifty six out of fifty six(100%) of patient died with IVH grade 3 and 4 when compared to grade 1 and 2 only three died (8%)all other babies in that group were discharged 34(92%).

CONCLUSION:

Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate.Preterm and VLBW infants have higher incidence of IVH. Antenatal risk factors and maternal antenatal steroid intake also influence the incidence of IVH in newborns.Need for assisted ventilation irrespective of the co morbidities, presence of shock, have been associated with increased incidence of IVH.Deranged coagulation profile have been associated with increased risk for the incidence of IVH in newborns.