| PrefaceIntraventricular hemorrhage ( IVH) in premature infants has seriously effects on premature infants and has been a major cause of mortality in premature infants. The morbidity is 65%. About 25% -50% early IVH has been neglected because there is no symptom in early stage, and there is no effective therapy to the severe complications ( posthaemorrhagic progressive ventricular dilatation (PVD) , hydrocephaly). Therefore, it is the most important to diagnose and interfere early on the IVH. This is a prospective study on the effects of associated perinatal factors to the incidence of IVH using bedside cranial ultrasound scans, and also the observation of luminal s effects on these neonates with different ges-tational age, different birth weigh has been conducted.Materials and MethodsThe present study was carried at the neonatal care units of shenyang obstetric and gynecologic hospital. 114 patients admitted between Feb, 2003 and March, 2004 were eligible for the study. All the premature infants were randomly divided into two groups. Group 1 is interfere group (take luminal) and Group 2 is the control group ( not take luminal). The infants in Group 1 were taken luminal 6 hours after birth and were detected prothrombin time(PT) , fibrinogen (FIB) and activated partial thromboplastin time( APTT) in the first 24 hours of life. NAS -2000A 3D ultrasound diagnose instrument for bed - side ultrasound detection were used to observe the infants. The data of these infants and motherswere collected. We use x2 - test to compare the incidence of IVH. The data of blood biochemistry tests are denoted as x s. T - test was used to compare the difference between groups. Multivariate logistic regression analysis was used in the analysis of relationship between associated risk factors and IVH. MS software and excel data analysis software were used on the statistical management.ResultThe incidence of IVH of premature infants below 34 weeks gestation is 43. 75% , which is higher than that of infants above 35 weeks gestation. The incidence of IVH of infants whose birth weight were below 1500 g is 58. 82% , which is higher than that of infants whose birth weight were above 1500 g. The incidence of IVH increased as a function of decreasing gestational age and birth weight.The study showed such risk factors as asphyxia, pregnancy induced hypertension syndrome ( PIH) of mothers had statistically significant association with the incidence of IVH (P<0.01) , while the different sex and delivery way had no correlation with the incidence of IVH (P >0. 05) . Coagulation factors have something to do with the incidence of IVH. In Multivariate analysis gestational age and asphyxia are closely related with the IVH.The compare between Group 1 and Group 2 showed that luminal could decrease the incidence of IVH of the premature infants whose gestational age were below 34 weeks, but luminal had no effects on those above 35 weeks gestational age. And there no ststistical significance on other factors such as birth weight, asphyxia or PIH.ConclusionIt is a cheapest way to have a bedside ultrasound scans for the early diagnosis of IVH in premature infants. Risk factors such as short gestational age, low birth weight, relatively prolongation of PT and APTT, asphyxia and PIH of mothers are associated with the IVH in premature infants. Short gestational ageand asphyxia are closely related with the IVH.It can prevent the incidence of IVH to use luminal to the premature infants of 34 weeks of gestational age within 6 hours after birth.
|
PDF Full Text Request