Ultrasound Diagnosis And Study Of The High-risk Neonatal Periventricular-intraventricular Hemorrhage

ObjectiveTo explore the clinical factors associated with occurrence of the high-risk neonatal periventricular-intraventricular hemorrhage(PIVH);to evaluate the application value of the high-risk neonatal mild PIVH by cranial ultrasound.Methods1. All 1768 high-risk neonates who were born and hospitalized in Neonatology department of Guangzhou Women and Children's Medical Center were examined bedside by cranial ultrasound between Jan.2010 and Jan.2011.2. According to Papile,the classfication of grades of PIVH ranges from I to IV, in which grade I and grade II of mild PIVH; grade III and IV of severe PIVH. Grades of PIVH include grade I, hemorrhage confined to the subependymal germinal matrix; grade II, hemorrhage into the lateral ventricles without ventricular dilatation; grade III, intraventricular hemorrhage with ventricular dilatation; and grade IV, intraventricular hemorrhage with periventricular hemorrhagic infarction. 3. The data were analyzed by SPSS17.0, and chi-square test was used. P value of less than 0.05 was considered to be statistically significant.Results91 cases were diagnosed as PIVH by ultrasound. Of the 91 cases, mild PIVH accounted for 80.2%(73/91), severe PIVH accounted for 19.8%(18/91). 62 cases (68.1%)were premature infants, 49 cases(53.8 %) were low birth weight infants. Gestational age from 32 weeks to 37 weeks cases in PIVH,severe PIVH accounted for 13.3%; gestational age < 32 weeks in PIVH, severe PIVH 41.2%; there was a statistically significant difference of severe incidence between these two groups(P =0.0401). Birth weight from 1.5 kg to 2.5 kg in PIVH, severe PIVH 8.8%; birth weight < 1.5kg in PIVH, severe PIVH 40.0%; the difference of severe incidence between these two groups was statistically significant(P =0.0280).ConclusionPIVH detected in premature infants, the smaller gestational age, the higher severe PIVH incidence;PIVH detected in low birth weight infants, the lower birth weight, the higher severe PIVH incidence and more serious the degree of hemorrhage. PIVH neonates who are often no obvious clinical symptoms of mild hemorrhage are in the majority, so cranial ultrasound examination is a very effective and feasible tool for the high-risk neonates,and it provides an significant clinical basis for the early diagnosis, evaluating the degree of hemorrhage, observing the course of disease, estimating prognosis and directing treatment of PIVH.