J Korean Pediatr Soc.  1994 May;37(5):642-648.

Periventricular-Intraventricular Hemorrhage in the Full-term Infant

• Kim HS
• Kim BI
• Choi JW
• Yun CK
• Kim IO

Abstract

Intraventricular hemorrhage (IVH) is common in the premature infants and occurs mainly in subependymal germinal matrix. In contrast, IVH in the term infants is rare and different in pathogenesis and bleeding sites from those of the premature infants. Most studies of IVH in term infants have been studied by computerized tomography and postmortem examination. Brain ultrasonography which has become a frequently used diagnostic tool of IVH in the premature infants is reported to be also effective in diagnosis in the term infants. The study population comprised 11 term neonates admitted to the Neonatal Intensive Care Unit of Seoul National University Children's Hospital between July 1989 and June 1991, in whom IVH was diagnosed by ultrasonography. We analysed severity of birth asphyxia. ultrasonographic findings and clinical manifestations to investigate severity, timing, risk factors, and pathogenesis of IVH in the term neonates. 1) Apgar scores were available in 7 cases with severe asphyxia (Apgar at 1 min: less than 3), 1 cases with mild asphyxia (Apgar at 1 min: between 5~7), and 2 cases without asphyxia. 2) Clinically, 4 cases had fetal distress, and 3 cases had meconium aspiration pneumonia. 3) Bleeding sites by ultrasonography were subependymal germinal matrix in all 11 cases. IVH of choroid plexus was combined in 2 cases. Severity of IVH were grade I in 9 cases, grade II in 2 cases by Papile's classification. 4) There were no correlations between the grade of IVH and severity of perinatal asphyxia. In conclusion, ultrasonography is very useful in diagnosis and follow-up of IVH in term neonates. Subependymal germinal matrix could be common site of IVH in term neonates because germinal matrix still remains in term neonates despite of its regression. Also this can explain why IVH in our cases is not severe.

MeSH Terms

Asphyxia
Autopsy
Brain
Choroid Plexus
Classification
Diagnosis
Fetal Distress
Follow-Up Studies
Hemorrhage*
Humans
Infant*
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal
Meconium Aspiration Syndrome
Parturition
Pneumonia
Risk Factors
Seoul
Ultrasonography