Obeid Rawad, Chang Taeun, Bluth Eresha, Forsythe Caitlin, Jacobs Marni, Bulas Dorothy, Oluigbo Chima, Penn Anna
Department of Neurology, Nemours/ A. I. duPont Hospital for Children, Washington, DE, USA.
Department of Neurology, Children's National Health System, Washington, DC, USA.
J Perinatol. 2018 Apr;38(4):374-380. doi: 10.1038/s41372-017-0017-3. Epub 2017 Dec 19.
The objective of this study is to describe clinical and ultrasound changes in a cohort of premature newborns with post-hemorrhagic ventricular dilation (PHVD), and to correlate these changes with outcome.
Premature newborns <29 weeks gestational age (GA) and ≤ 1,500 g birth weight with intraventricular hemorrhage were retrospectively reviewed. Clinical signs and cranial ultrasound (CUS) findings between time after birth and time before first cerebrospinal fluid temporizing intervention were compared with GA-equivalent newborns without interventions. White matter injury was assessed on brain magnetic resonance imaging.
Between 2011 and 2014, 64 newborns met inclusion criteria; 23% had PHVD. The growth rates of the ventricles on CUS and the head circumference (HC) were higher in newborns with PHVD (p < 0.01 and p = 0.04, respectively) and correlated inversely with white matter injury (p = 0.006 and p < 0.001, respectively).
Progression of PHVD in premature newborns as demonstrated by CUS and the HC correlated with outcome. Consistent measurement of these simple parameters will allow for much needed treatment comparisons, to define optimal protocols that decrease the risk of cerebral palsy in extremely preterm populations.
本研究的目的是描述一组患有出血后脑室扩张（PHVD）的早产儿的临床和超声变化，并将这些变化与预后相关联。
对孕周<29周且出生体重≤1500克的患有脑室内出血的早产儿进行回顾性研究。将出生后至首次脑脊液临时干预前的临床体征和头颅超声（CUS）检查结果与未接受干预的孕周相当的新生儿进行比较。通过脑磁共振成像评估白质损伤情况。
在2011年至2014年期间，64名新生儿符合纳入标准；23%患有PHVD。患有PHVD的新生儿的CUS脑室生长速率和头围（HC）更高（分别为p<0.01和p=0.04），且与白质损伤呈负相关（分别为p=0.006和p<0.001）。
CUS和HC显示的早产儿PHVD进展与预后相关。持续测量这些简单参数将有助于进行急需的治疗比较，以确定降低极早产儿脑瘫风险的最佳方案。
