[Sonographically diagnosed subependymal intraventricular hemorrhage in clinically inconspicuous newborn infants and their relation to perinatal factors].

With an intracranial ultrasound screening at the University Clinic of Obstetrics and Gynaecology, Wuerzburg, a subependymal/intraventricular haemorrhage (SEH/IVH) was observed in 37 cases (5.5%). Of the analyzed maternal, obstetric and neonatal variables as possible risk factors of SEH/IVH, SEH/IVH was significantly more frequent in male newborns, first- and secondborn children and in infants of very young mothers, whereas it was significantly less frequently found after rupture of the membranes with the cervix fully dilated and in large-fordates infants. Factors like mode of delivery, presentation, duration of labour, drugs sub partu, maternal injuries, oligohydramnios, meconium staining, coiling of the umbilical cord, birth weight and size, post-maturity, hypotrophy, umbilical cord blood gas analysis, and Apgar score did not show a significant correlation to SEH/IVH. Multivariate analysis only substantiated an independent association between gender and SEH/IVH. Newborns with an umbilical artery pH less than or equal to 7.19 together with an one-minute Apgar score less than or equal to 8 had a four times higher bleeding rate than infants with normal pH and/or Apgar score. The mentioned parameters, however, are not appropriate to predict SEH/IVH in asymptomatic newborns. The appearance of SEH/IVH is usually due to a combination of events rather than to a single factor. The role of raised head compression and intrapartual hypoxia in the causation of SEH/IVH in term newborns has to be clarified in further studies.