INTRAVENTRICULAR HEMORRHAGES OF NEWBORNS, CAUSES, COMPLICATIONS AND PREVENTION METHODS

Abstract

Introduction. Intraventricular hemorrhages (IVH) occupy a prominent place in the structure of perinatal lesions of the nervous system among newborns, especially premature birth. Knowledge of risk factors and pathogenic mechanisms of development of IVH, timely prophylaxis, early diagnostic and treatment of complications will significantly reduce infant mortality and severe distant neurological effects.Objective. Conduct a retrospective analysis of medical records among infants with IVH to determine the main risk factors, complications for improving of medical care to this group of patients.Materials and methods. In the basis of this work is the analysis of 148 stories of desease among children, who had IVH of varying degrees according neurosonography and computed tomography of the brain and were treated at Chernigiv Oblast Children’s Hospital during 2015-2018.Results. The article presents the results of the analysis of the morbidity of newborn infants with intraventricular hemorrhages for the period of 2015-2018on the basis of the Chernigiv Oblast Children's Hospital. The main risk factors were identified. At the forefront are׃ asphyxia in labor gestational age(premature infants were 72.3 %), mechanical ventilation with severe parameters, mother's infection, acute hypoxia in labor, thrombocytopenia. Reliable connection between the term of gestation and the frequency of occurrence of IVH is proved. Among all children with IVH, the majority werechildren with gestational age range 29-32 weeks, one third of which requiredhard-line mechanical ventilation, but a significantly lower percentage of surfactant versus group 22-28 weeks gestational age. That testifies to insufficient use of surfactant with preventive and curative purpose in this group. Most often, there are IVH of the I – II degrees. And the first stage is the majority of full-term children, the IVH of IV degree was noted only in children with gestational age up to 32 weeks. Children of this group have a rather long period of stay in the intensive care units. Separately considered are their complications and basic methods oftreatment. Posthemorrhagic non-occlusal hydrocephalus was observedpredominantly among children with gestational age 22-28 weeks and termed infants 37-42 weeks, who suffered IVH III (52.6 %), nobody needed surgical intervention and mortality amounted to 10.5 %. Occlusion hydrocephalus is the prevailing majority of children with gestational age of 29-32 weeks (57.1 %), after IVH III (71.4 %), all of them had asphyxia at birth, meningitis and ventriculitis (71.4 %). These children required surgical treatment and a high mortality rate was observed (57.2 %).Conclusions. Looking at the long, complex, costly treatment, high mortality and the frequency of disability in this group of children, the main efforts should be directed towards prevention and timely surgical intervention for complications.