Abstract
In 112 VLBW neonates, intrapartum factors were prospectively evaluated in relation to the development of IVH. Real-time ultrasound was performed at a mean age of 27.3±17.1 hrs. Twenty-seven (24%) had IVH (20 Grade I, 2 Grade II, 2 Grade III, 3 Grade IV). Mean BW for the non-IVH group was 1087±268g vs 1019±279g for those with IVH. Males accounted for 48% of the non-IVH group and 62% of the IVH group(NS). Umbilical cord pH in 5(9%) of the non-IVH group and in 3(14%) of the IVH group was less than 7.20(NS). There was no difference in antepartum/intrapartum maternal or fetal complications. The incidence of abnormal FHR patterns and rate of abnormal presentations and duration of labor were similar in both groups. C-section with/without labor provided no advantage over vaginal delivery. Of 6 vaginal breech deliveries there was 1 infant with IVH(Grade I). Although incidence of RDS and volume expansion were similar, the need of assisted ventilation (AV) was higher in the IVH group(.05). Due to the low rate of major IVH (Grade III and IV, 4.4%) 12 pairs of infants were matched for BW within 100g. The 5 min. Apgar score was lower in infants with major IVH(.05). There was no difference in abnormal FHR patterns, breech presentation, mode of delivery and 1 min. Apgar score. Use of c-section for fetal distress in VLBW infants did not prevent IVH. The degree of neonatal depression in combination with AV rather than intrapartum factors/fetal distress with acidosis may be an important factor in determining the occurrence of major IVH.
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Strauss, A., Kirz, D., Modanlou, H. et al. INTRAPARTUM FACTORS AND INTRAVENTRICULAR HEMORRHAGE (IVH) IN VERY LOW BIRTH WEIGHT (VLBW) INFANTS. Pediatr Res 18 (Suppl 4), 380 (1984). https://doi.org/10.1203/00006450-198404001-01723
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DOI: https://doi.org/10.1203/00006450-198404001-01723