scholarly journals Germinal Matrix-Intraventricular Hemorrhage: A Tale of Preterm Infants

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Walufu Ivan Egesa ◽  
Simon Odoch ◽  
Richard Justin Odong ◽  
Gloria Nakalema ◽  
Daniel Asiimwe ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Preterm Neonates ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Germinal Matrix ◽  
Posthemorrhagic Hydrocephalus ◽  
Management Interventions ◽  
Incidence Risk

Germinal matrix-intraventricular hemorrhage (GM-IVH) is a common intracranial complication in preterm infants, especially those born before 32 weeks of gestation and very-low-birth-weight infants. Hemorrhage originates in the fragile capillary network of the subependymal germinal matrix of the developing brain and may disrupt the ependymal lining and progress into the lateral cerebral ventricle. GM-IVH is associated with increased mortality and abnormal neurodevelopmental outcomes such as posthemorrhagic hydrocephalus, cerebral palsy, epilepsy, severe cognitive impairment, and visual and hearing impairment. Most affected neonates are asymptomatic, and thus, diagnosis is usually made using real-time transfontanellar ultrasound. The present review provides a synopsis of the pathogenesis, grading, incidence, risk factors, and diagnosis of GM-IVH in preterm neonates. We explore brief literature related to outcomes, management interventions, and pharmacological and nonpharmacological prevention strategies for GM-IVH and posthemorrhagic hydrocephalus.

scholarly journals Germinal Matrix Hemorrhage: Intraventricular Hemorrhage in Very-Low-Birth-Weight Infants

Stroke ◽  
2011 ◽  
Vol 42 (7) ◽  
pp. 1889-1893 ◽  
Author(s):  
Luca A. Ramenghi ◽  
Monica Fumagalli ◽  
Michela Groppo ◽  
Dario Consonni ◽  
Loredana Gatti ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Germinal Matrix ◽  
Germinal Matrix Hemorrhage

Developmental Outcome of Very Low Birth Weight Infants with Intraventricular Hemorrhage

1993 ◽  
Vol 77 (3) ◽  
pp. 894-894 ◽  
Author(s):  
Anna J. Whitehead
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Poor Prognosis ◽  
Very Low Birth Weight ◽  
Ventricular Dilatation ◽  
Developmental Outcome ◽  
Low Birth Weight Infants

Analyses of data from 20 infants confirmed that ventricular dilatation in VLBW preterm infants carries poor prognosis for development, but not IVH alone.

Trends in hospitalization of preterm infants with intraventricular hemorrhage and hydrocephalus in the United States, 2000–2010

2016 ◽  
Vol 17 (3) ◽  
pp. 260-269 ◽  
Author(s):  
Eisha A. Christian ◽  
Diana L. Jin ◽  
Frank Attenello ◽  
Timothy Wen ◽  
Steven Cen ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Preterm Infants ◽  
Hospital Cost ◽  
Intraventricular Hemorrhage ◽  
Preterm Births ◽  
The United States ◽  
Preterm Neonates ◽  
Average Hospital ◽  
Posthemorrhagic Hydrocephalus ◽  
Congenital Cardiac Anomalies

OBJECT Even with improved prenatal and neonatal care, intraventricular hemorrhage (IVH) occurs in approximately 25%–30% of preterm infants, with a subset of these patients developing hydrocephalus. This study was undertaken to describe current trends in hospitalization of preterm infants with posthemorrhagic hydrocephalus (PHH) using the Nationwide Inpatient Sample (NIS) and the Kids’ Inpatient Database (KID). METHODS The KID and NIS were combined to generate data for the years 2000–2010. All neonatal discharges with ICD-9-CM codes for preterm birth with IVH alone or with IVH and hydrocephalus were included. RESULTS There were 147,823 preterm neonates with IVH, and 9% of this group developed hydrocephalus during the same admission. Of patients with Grade 3 and 4 IVH, 25% and 28%, respectively, developed hydrocephalus in comparison with 1% and 4% of patients with Grade 1 and 2 IVH, respectively. Thirty-eight percent of patients with PHH had permanent ventricular shunts inserted. Mortality rates were 4%, 10%, 18%, and 40%, respectively, for Grade 1, 2, 3, and 4 IVH during initial hospitalization. Length of stay has been trending upward for both groups of IVH (49 days in 2000, 56 days in 2010) and PHH (59 days in 2000, 70 days in 2010). The average hospital cost per patient (adjusted for inflation) has also increased, from $201,578 to $353,554 (for IVH) and $260,077 to $495,697 (for PHH) over 11 years. CONCLUSIONS The number of neonates admitted with IVH has increased despite a decrease in the number of preterm births. Rates of hydrocephalus and mortality correlated closely with IVH grade. The incidence of hydrocephalus in preterm infants with IVH remained stable between 8% and 10%. Over an 11-year period, there was a progressive increase in hospital cost and length of stay for preterm neonates with IVH and PHH that may be explained by a concurrent increase in the proportion of patients with congenital cardiac anomalies.

scholarly journals The Prognosis of Refractory Hypotension and Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants

2021 ◽  
Author(s):  
Seok Hwang-Bo ◽  
Yu-Mi Seo ◽  
Moon-Yeon Oh ◽  
Soo-Ah Im ◽  
YoungAh Youn
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Developmental Delay ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Periventricular Leukomalacia ◽  
Pulmonary Hemorrhage ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Refractory Hypotension

Abstract Background: The increased survival rate among very low birth weight infants has resulted in a higher risk for developing neurocomplications such as intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and adverse neurodevelopmental outcomes.Purpose: We examined refractory hypotension experienced within a week of life in association with severe IVH (grades 3-4) among very low birth weight infants (VLBWIs).Method: Between Jan 2014 and Dec 2017, the clinical data of 191 VLBWIs admitted were retrospectively reviewed. Of a total of 191 VLBWIs, 71.2% (136/191) had IVH, and 28.7% (55/191) had severe IVH.Results: The VLBWI with severe IVH group (grade 3-4) presented with a significantly lower gestational age along with higher use of postnatal hydrocortisone for refractory hypotension. Resuscitation at delivery, pulmonary hemorrhage, neonatal seizure, and periventricular leukomalacia (PVL) were significantly more frequent in the severe IVH group (p<0.05). Higher mortality occurred in the VLBWI with severe IVH group (p<0.001). The multivariable logistic regression analysis consistently showed that refractory hypotension within a week of life and neonatal seizures were significantly associated with severe IVH. Those in the severe IVH and refractory hypotension groups had significantly lower composite cognitive, language, motor, and Bayley Scales of Infant and Toddler Development III scores at corrected 18 months.Those in the severe IVH and refractory hypotension groups showed significant developmental delay.Conclusion: Refractory hypotension within a week of life and seizures were consistently associated with severe IVH. VLBWI who experienced refractory hypotension within a week of life may indicate a more vulnerable perinatal settings with a higher risk for developmental delay.

scholarly journals A Case Report of Neonatal posthemorrhagic hydrocephalus in a premature infant.

2020 ◽  
Vol 1 (3) ◽  
pp. e253
Author(s):  
Kiran Niraula ◽  
Ali Niyaf ◽  
Dusooma Abdul Razzag ◽  
Manoj Gautam ◽  
Yujan Sapkota ◽  
...  
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Very Low Birth Weight ◽  
Communicating Hydrocephalus ◽  
Low Birth Weight Infants ◽  
Germinal Matrix ◽  
Posthemorrhagic Hydrocephalus ◽  
Case Presentation ◽  
Male Baby ◽  
Ventricular Hemorrhage

Background: Neurosurgical services in the Maldives began around five years ago, but the first neurosurgical center is responsible for various emergency and clinical neurosurgical services. Published literature on neurosurgery from the Maldives Islands is limited. It is imperative to report unique cases from isolated countries to promote diversity for readers across the globe. Case Presentation: We present a case of a ventriculo-subgaleal shunt placement in an extremely premature male baby with intra-ventricular hemorrhage, causing communicating hydrocephalus born at 22 weeks of gestation weighing 600 grams to a young primigravida. The shunt was performed in the first month of life (780 grams) for communicating hydrocephalus secondary to the germinal matrix bleed into the ventricles. Conclusion: Ventriculo-subgalel shunt under local anesthesia is a promising measure to treat hydrocephalus in pre-term very low birth weight infants secondary to germinal matrix hemorrhage.

Technical Nuances in Neuroendoscopic Lavage for Germinal Matrix Hemorrhage in Preterm Infants: Twenty Tips and Pearls after More than One Hundred Procedures

2021 ◽  
pp. 1-9
Author(s):  
Jorge Tirado-Caballero ◽  
Jorge Herreria-Franco ◽  
Mónica Rivero-Garvía ◽  
Gloria Moreno-Madueño ◽  
Maria Jose Mayorga-Buiza ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Cerebrospinal Fluid Leak ◽  
Tips And Tricks ◽  
Germinal Matrix ◽  
Suitable Alternative ◽  
Posthemorrhagic Hydrocephalus ◽  
Mortality And Morbidity ◽  
Germinal Matrix Hemorrhage ◽  
Preoperative Stage ◽  
Fluid Leak

<b><i>Introduction:</i></b> Posthemorrhagic hydrocephalus in preterm infants is a serious entity related to high mortality and morbidity. Neuroendoscopic lavage (NEL) is a suitable alternative for the management of this pathology. However, as with every endoscopic technique, it requires some experience and several cases to master. <b><i>Methods:</i></b> We present a descriptive study of some technical nuances, tips, and tricks that have been learned in the last 8 years with over a hundred NELs performed in preterm infants. These variations are classified into 3 categories according to their temporal relationship with the surgical procedure: preoperative stage, intraoperative stage, and postoperative stage. We include a brief description of each one and the reasons why they are included in our current clinical practice. <b><i>Results:</i></b> Twenty tips and pearls were described in detail and are reported here. Preoperative, intraoperative, and postoperative variations were exposed and related to the most frequent complications of this procedure: infection, cerebrospinal fluid leak, and rebleeding. <b><i>Conclusions:</i></b> NEL is a useful technique for the management of germinal matrix hemorrhage in preterm infants. These technical nuances have improved the results of our technique and helped us to prevent complications related to the procedure.

scholarly journals A Systematic Review and Meta-Analysis of Human Milk Feeding and Short-Term Growth in Preterm and Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2089
Author(s):  
Machiko Suganuma ◽  
Alice R. Rumbold ◽  
Jacqueline Miller ◽  
Yan Fong Chong ◽  
Carmel T. Collins
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Poor Quality ◽  
Low Birth Weight Infants ◽  
Preterm Formula ◽  
Meta Analyses

Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.

scholarly journals ANALYSIS OF THE DIFFERENCES BETWEEN THE PRESCRIBED AND THE ADMINISTERED DIET TO PRETERM INFANTS USING AN ELECTRONIC TOO

2019 ◽  
Vol 37 (4) ◽  
pp. 472-478 ◽  
Author(s):  
Olivia Araújo Zin ◽  
Fernanda Valente Mendes Soares ◽  
Andrea Dunshee de Abranches ◽  
Ana Carolina Carioca da Costa ◽  
Letícia Duarte Villela ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Body Weight Gain ◽  
Nutritional Deficiencies ◽  
Percentage Error ◽  
Electronic Instrument ◽  
Health Providers ◽  
Low Birth Weight Infants

ABSTRACT Objective: To create an electronic instrument in order to analyze the adequacy of the preterm infants’ nutritional therapy, checking the difference between the prescribed and the administered diet. Methods: A prospective and observational study on newborns with birthweight ≤1,500g and/or gestational age ≤32 weeks, without congenital malformations. The electronic instrument was developed based on Microsoft Excel 2010 spreadsheets and aimed at automatically calculating body weight gain, calories and macronutrients received daily by each patient from parenteral nutrition, intravenous hydration and enteral feedings. The weekly means of each nutrient were used to compare the prescribed and administered diets. Results: To evaluate the instrument, 60 newborns with a birth weight of 1,289±305 g and a gestational age of 30±2 weeks were included. Of them, 9.6% had restricted growth at birth and 55% at discharge. The median length of stay was 45±17 days. There were significant differences between prescribed and administered diet for all of the macronutrients and for total calories in the first three weeks. The lipid was the macronutrient with the greatest percentage error in the first week of life. Conclusions: The use of a computational routine was important to verify differences between the prescribed and the administered diet. This analysis is necessary to minimize calculation errors and to speed up health providers’ decisions about the nutritional approach, which can contribute to patients’ safety and to good nutritional practice. Very low birth weight infants are extremely vulnerable to nutritional deficiencies and any reduction in macronutrients they receive may be harmful to achieve satisfactory growth.

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