Intracranial Hemorrhages in preterm newborns.

Abstract

Premature infants are at high risk for the development of hemorrhagic or ischemic cerebral injury, which contributes significantly to neonatal mortality as well as long term neurodevelopmental deficits. Peri and intraventricular hemorrhage is the most common lesion in the mildest form, it is confined to the germinal matrix; in more severe cases, it is complicated by bleeding into the periventricular white matter. By means of a descriptive study, an investigation was carried out to assess the incidence of intraventricular hemorrhage in the neonatal intensive care unit of Albert Sabin hospital in the city of Juiz de Fora, Minas Gerais state, from February 1993 to September 2003. Within this period, all cases of peri and intraventricular hemorrhage occurred in the neonatal intensive care unit of Albert Sabin hospital were studied. Data from 331 files were analysed with respect a gestacional age, lower birth weight (<1500g), intubation, respiratory distress syndrome, neonatal sepsis, ductus arteriosus patentis, blood transfusions and mechanical ventilation. The main reasons for peri and intraventricular hemorrhage occurred were: decreasing gestacional age, lower birth weight (<1500g), intubation and respiratory distress syndrome. Interestingly surfactant administration with improved respiratory function has not been associated with a reduction in the incidence of intraventricular hemorrhage. All cases of peri and intraventricular hemorrhage were diagnosed by ultrasonography cranial, and were relationed with a procedure that alter the venous and arterial pressure in the brain vascular bed. Factors associated with an increased risk in the present study include decreasing gestacional age, lower birth weight (<1500g), intubation, neonatal sepsis and respiratory distress syndrome. Key-words: Intracranial hemorrhages. Infant, Newborn. Neonatology.