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Intraventricular hemorrhage of the newborn - Overview

Alternative Names

IVH - newborn

Definition of Intraventricular hemorrhage of the newborn :

Intraventricular hemorrhage (IVH) of the newborn is bleeding into the fluid-filled areas (ventricles) surrounded by the brain. The condition is most often seen in premature babies.

Causes, incidence, and risk factors:

Infants born before 30 weeks of pregnancy are at highest risk for such bleeding. The smaller and more premature the infant, the higher the risk for IVH. This is because blood vessels in the brain of premature infants are not yet fully developed and are extremely fragile. The blood vessels grow stronger after 30 weeks of pregnancy.

IVH is more common in premature babies who have had physical stress, such as respiratory distress syndrome, pneumothorax, or high blood pressure. The condition may also occur in healthy premature babies who were born without injury. IVH may develop in full-term babies, but this is very uncommon.

IVH is rarely present at birth. If it occurs, it will usually be in the first several days of life. The condition is quite rare after 1 month of age, no matter how early the baby was born.

IVH falls into four groups, called grades. The higher the grade, the more severe the bleeding.

Grades 1 and 2 involve a small amount of bleeding and do not usually cause long-term problems.

Grades 3 and 4 involve more severe bleeding, which presses on or leaks into brain tissue. Blood clots can form and block the flow of cerebrospinal fluid, leading to increased fluid in the brain (hydrocephalus).

  • Reviewed last on: 9/13/2007
  • Alan Greene, MD, FAAP, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children's Hospital; Chief Medical Officer, A.D.A.M., Inc. Also reviewed by Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.

References

Hansen TW. Prophylaxis of intraventricular hemorrhage in premature infants: new potential tools, new potential challenges. Pediatr Crit Care Med. Jan 2006; 7(1): 90-2.

Futagi Y. Neurodevelopmental outcome in children with intraventricular hemorrhage. Pediatr Neurol. Mar 2006; 34(3): 219-24.44

Gabbe SG, Niebyl JR, Simpson JL. Obstetrics - Normal and Problem Pregnancies. 4th ed. New York, NY: Churchill Livingstone; 2002:974-983.

Ment LR. Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. Jun 2002; 58(12): 1726-38.