Neonatal - Interventricular haemorrhage

Question 1

Definition

Answer 1

intracranial haemorrhage originating in periventricular subependymal area with blood then into ventricular system

Question 2

early IVH

Answer 2

within 72hrs

Question 3

late IVH

Answer 3

after 72hrs

Question 4

incidence

Answer 4

30% infants <1500g

Question 5

pathophysiology

Answer 5

unsupported blood vessels in subependymal germinal matrix

instability of bp associated with birth trauma and resp distress

Question 6

what may decrease incidence in prems?

Answer 6

delayed clamping cord

Question 7

Risk factors

Answer 7

PREMATURITY
hypertension 
coagulopathies 
rapid volume expansion
anaemia, vacuum, acidosis

Question 8

clinical features

Answer 8

asymptomatic
apnoea, bradycardia, acidosis, cutaneous mottling, bulging fontanelle, high pitched cry
absent moro reflex
seizures

Question 9

large IVH features

Answer 9

rapid onset coma
seizures
pupils fixed to light

Question 10

diagnosis

Answer 10

USS and MRI

Question 11

how many grades?

Answer 11

4

Question 12

antenatal prevention

Answer 12

avoid preterm delivery
vitamin K to those on phenytoin
c section high risk
antenatal CCS

Question 13

postnatal prevention

Answer 13

avoid birth asphyxia
avoid rapid infusion, excess handling
correct acid base and coagulation

Question 14

complications

Answer 14

posthaemorrhagic hydrocephalus
seizures
irreversible brain damage
death