Abstract
Using our perinatal data bank, clinical and pathological data on 104 sigleton infants who died with germinal layer haemorrhage and intraventricular haemorrhage /IVH/ at Hammersmith were analyzed in comparison with data from babies dying of other conditions, and with the background population. Of 31 cases of IVH without hyaline membrane disease /HMD/ only four infants were born at a gestation of 30 weeks or more, whereas in 73 cases of IVH with HMD 49 were born at over 30 weeks gestation. At all gestations infants who died with HMD + IVH had received more intense alkali therapy than those who died with HMD alone, although there was no difference in acid-base status or PaO2 measurements. Administration of alkali /THAM and bicarbonate/ in excess of 8 mEq/Kg body weight over any 12 hour period was significantly associated with the development of IVH. In babies of 30 weeks gestation or less the association between IVH and alkali therapy was significant whereas the association with HMD was not. It is suggested that the expansion of blood volume caused by administration of hypertonic solutions for treatment of HMD may be a significant factor in the causation of IVH.
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