Magnitude of Intraventricular Hemorrhage in Neonates Born Below 32 Weeks of Gestational Age at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, 2019

Abstract

Abstract Background: Intraventricular / germinal matrix hemorrhage (IVH/GMH) remains a significant cause of both morbidity and mortality in infants who are born prematurely. Sequelae of GM/IVH include short- and long-term complications and can result in life-long neurologic deficits, specifically cerebral palsy, developmental delay, and seizures. GM/IVH is diagnosed primarily through the use of brain imaging studies, usually cranial ultrasonography. Because GM/IVH can occur without clinical signs, screening and serial examinations are necessary for the diagnosis. Objective: The aim of this study was to determine magnitude and grades of intraventricular hemorrhage in newborns born below 32 weeks of gestational age and admitted at Saint Paul’s Hospital Millennium Medical College(SPHMMC) neonaltal intensive care unit(NICU). Methods: This was a prospective cross sectional study where 97 preterm neonates meeting the study's inclusion criteria had cranial ultrasound done after the first 48 hours of age. Data on the risk factors was obtained from the neonatal referral form, maternal records and direct interview with the neonate's mother. Results: In this study, of the total 97 neonates,63 neonates (64.9%) had normal brain sonography, while 34 neonates (35.1%) had IVH/GMH. Grade 1 IVH was the most common(47.1%) followed by grade 2 IVH at 29.4%. This made mild IVH (grade 1 and grade 2) 76.5% of the total IVH cases detected. Grade 3 IVH was the third common at 20.6% and grade 4 IVH was the least making 2.9%. There was significant reduction in magnitude of IVH in those neonates whose mothers were given antenatal steroid (p=0.003, RR=0.45, 95%CI 0.26-0.76). Conclusion and recommendations: The magnitude of IVH in very preterm/VLBW neonates is high, therefore all very preterm/VLBW neonates should be serially scanned. Antenatal steroid administration significantly decreases magnitude of IVH. Hence, antenatal steroid should be administered to pregnant women at risk for preterm delivery. Key words: Transfontanelle ultrasound, Intraventricular hemorrhage, Preterm neonate.