scholarly journals Treatment of hydrocephalus in premature infants with intraventricular hemorrhage - placing Omaya reservoir: A series of 30 patients

2013 ◽  
Vol 60 (4) ◽  
pp. 59-64
Author(s):  
Miljan Mihajlovic ◽  
Milan Mrdak ◽  
Nikola Repac ◽  
Igor Nikolic ◽  
Igor Djoric ◽  
...  

Introduction. We report a series of 30 patients with spontaneous intraventricular hemorrhage (IVH) and hydrocephalus, in which is placed subcutaneous (Omaya) tank at the University Children?s Hospital in Belgrade from March 2006 to March 2011. Results. Predictors of poor outcome in treatment in getting Omaya reservoirs are low birth weight (t=2.560, p=0.016), low Apgar score (t=3.059, p=0.005), an extended number of days on mechanical ventilation (Z=4,404 , p< 0.001), the presence of peripartal asphyxia (X2=9.977, p=0.002) and cardio-respiratory arrest (X2=12.804 , p< 0.001). Conclusion. The outcome of treatment of hydrocephalus caused by spontaneous intraventricular hemorrhage in premature infants is worst in perinatology. There is no consensus on the diagnosis and treatment of posthemorrhage hydrocephalus, our results suggest that the main prediction factor is preoperative condition of the child.

1999 ◽  
Vol 54 (5) ◽  
pp. 151-154 ◽  
Author(s):  
Monique Catache Mancini ◽  
Naila Elias Barbosa ◽  
Débora Banwart ◽  
Sandra Silveira ◽  
José Luiz Guerpelli ◽  
...  

Intraventricular hemorrhage (IVH) is a severe complication in very low birth weight (VLBW) newborns (NB). With the purpose of studying the incidence of IVH, the associated risk factors, and the outcomes for these neonates, we studied all the VLBW infants born in our neonatal unit. Birth weight, gestational age, presence of perinatal asphyxia, mechanical ventilation, length of hospitalization, apnea crisis, hydrocephalus, and periventricular leukomalacia were analyzed. The diagnosis of IVH was based on ultrasound scan studies (Papile's classification) performed until the tenth day of life and repeated weekly in the presence of abnormalities. Sixty-seven/101 neonates were studied. The mortality rate was 30.6% (31/101) and the incidence of IVH was 29.8% (20/67) : 70% grade I, 20% grade III and 10% grade IV. The incidence of IVH in NB <1,000 g was 53.8% (p = 0.035) and for gestational age <30 weeks was 47.3% (p = 0.04), both considered risk factors for IVH. The length of hospitalization (p = 0.00015) and mechanical ventilation (p = 0.038) were longer in IHV NB. The IVH NB had a relative risk of 2.3 of developing apnea (p = 0.02), 3.7 of hydrocephalus (p = 0.0007), and 7.7 of periventricular leukomalacia (p < 0.00001). The authors emphasize the importance of knowing the risk factors related to IVH so as to introduce prevention schemes to reduce IVH and to improve outcomes of affected newborns.


2021 ◽  
Author(s):  
Baoquan Zhang ◽  
Xiujuan Chen ◽  
Changyi Yang ◽  
Huiying Shi ◽  
Wenlong Xiu ◽  
...  

Abstract Purpose This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the mortality and complications in very low birth weight neonates. Methods Premature infants at a gestational age of < 37 weeks with a birth weight of < 1,500g were included in this retrospective analysis. Gestational age-matched pregnant women with normal blood pressure giving birth to a very low birth weight neonate served as normal control. HDP neonates were divided into three subgroups based on the disease severity, including gestational hypertension, pre-eclampsia and eclampsia. Then we compared the incidence of complications among three subgroups. We also analyzed the relationship between the subgroups and the neonatal prognosis. Results The incidence of fetal distress, small for gestational age (SGA), mechanical ventilation, neonatal respiratory distress syndrome (RDS), neonatal necrotizing enterocolitis (NEC, ≥ 2 stage), and mortality in HDP group were significantly higher than those of the control. The 1 min Apgar score in HDP group was significantly lower than that of the normal control (P < 0.05). There were significant differences in fetal distress, 1 min Apgar score, mechanical ventilation, RDS and NEC (≥ 2 stage) among HDP, pre-eclampsia and eclampsia subgroups (P < 0.05). Multivariate regression analysis indicated that pre-eclampsia was an independent risk factor for SGA (OR = 4.123, 95%CI: 2.783–6.109) and NEC (OR = 2.493, 95%CI: 1.161–5.351). Eclampsia was a risk factor for SGA (OR = 3.804, 95%CI: 1.239–11.681) and NEC (OR = 7.264, 95%CI: 1.771–29.797). Conclusions HDP may affect the prognosis of very low birth weight neonates. Pre-eclampsia and eclampsia were risk factors for SGA and NEC.


2021 ◽  
pp. 20-29
Author(s):  
Olga A. Milovanova ◽  
Dzhenneta Y. Amirkhanova ◽  
Alyona K. Mironova ◽  
Maryam M. Dzhukkayeva ◽  
Olga A. Komissarova ◽  
...  

Introduction. Premature infants are at risk of developing central nervous system malformations; therefore, increased survival rates among infants with very low birth weight and extremely low birth weight have contributed to the rise in prevalence of neurologic deficit in extremely premature infants.Purpose. To summarize the literature data and demonstrate rare family clinical observations of preterm infants associated with adverse neurological outcomes as a result of exposure to various perinatal factors.Materials and methods. For the literature review, we used data from full-text scientific research from international scientific databases. The influence of ante-, intra-, and postnatal risk factors on the neurological outcome of the disease was studied in two male sibs born at 27 weeks of gestation with a weight of 980 and 970 grams, a body length of 34 and 33 cm, and an Apgar score of 5/7 and 6/7, respectively. The analysis of anamnestic data and results of clinical and laboratory-instrumental examination was performed; the catamnestic observation was 24 adjusted months of life.Results.The presented observations revealed a combination of various ante-, intra-and postnatal risk factors that lead to CNS damage in preterm infants. The obtained results indicate that prematurity and extremely low birth weight are not the only risk factors for neurological disorders, but the burdened neonatal period (congenital sepsis, bronchopulmonary dysplasia, lung atelectasis, neonatal convulsions, and 2-degree intraventricular hemorrhage verified by USC/MRI of the brain on both sides) contributed to the formation of neurogolic pathology in the second examined sibs. The results obtained can be considered preliminary, and a larger study is needed.Conclusion.Thus, the obtained results indicate that prematurity, extremely low birth weight and low Apgar score are not the only risk factors for the formation of neurological disorders. A combination of several significant ante-, intra-, and postnatal risk factors is necessary for the development of severe perinatal CNS damage, the formation of adverse neurological outcomes, and severe delay in motor and psycho - speech development in preterm infants. The prognosis of neurological outcome in a preterm baby requires long-term dynamic monitoring and a comprehensive approach using clinical and instrumental diagnostic methods. The results obtained can be considered preliminary, requiring additional more extensive research.


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