Posthemorrhagic Ventricular Dilatation in Premature Infants with Very Low Birth Weight: Natural History and Follow-up

OBJECTIVE: To investigate the natural history, including the short-and long-term outcome, of posthemorrhagic ventricular dilatation (PHVD) in very low birth weight (VLBW) infants. METHODS: A retrospective review was performed of the records of all VLB W infants admitted with intraventricular hemorrhage (IVH) to the neonatal intensive care unit of Mackay Memorial Hospital, Taipei, Taiwan between January 1998 and January 2002. RESULTS: One hundred thirty-one VLBW infants had evidence of IVH. Thirty-five infants (27%) died within the first 14 days of life, 23 of whom had high-grade IVH (grade Ⅲ or Ⅳ). The other 96 VLBW infants survived more than 14 days. Of these 96 infants, 31(32%) had ventricular dilatation, among whom 18 had spontaneous arrest of PHVD, 5 were treated non-surgically, 5 were treated surgically, and 4 died (including 1 who had undergone external ventricular drainage). At the follow-up examination at 24 months, 35% of the 23 survivors with PHVD scored less than 70 on the Bayley developmental scales. Among the 4 survivors who had VP shunts, all had developmental delay and/or cerebral palsy. The Mental Development Index and Psychomotor Development Index scores of VLBW infants with PHVD were significantly lower than those without PHVD at the 18- and 24-month follow-up assessments (p＜0.05). CONCLUSIONS: PHVD in VLBW infants is related to the severity of IVH and these infants have high mortality and a poor prognosis. For VLBW infants with PHVD who survive, the disorder has a substantial negative impact on mental and psychomotor development.

並列關鍵字

posthemorrhagic ventricular dilatation ； hydrocephalus ； intraventricular hemorrhage ； very low birth weight ； prematurity

國際替代計量

全文下載

主題瀏覽