Periventricular-intraventricular haemorrhage in low-birth-weight infants at Baragwanath Hospital.

The prevalence of periventricular-intraventricular haemorrhage (PV-IVH) among very-low-birth-weight infants at Baragwanath Hospital has not been well documented. In this prospective study, a total of 282 live-born infants with birth weights of 1,000-1,749 g were studied over a 4 1/2-month period. Every infant had at least one cranial ultrasound examination at 7-10 days of age, while one-third of non-ventilated and all ventilated infants had ultrasound examinations on days 3, 7 and 14. Where possible, all infants had a follow-up ultrasound scan at 40 weeks' post-conceptional age. The overall prevalence of PV-IVH was 53% for infants weighing less than 1,500 g at birth and 52% for infants born at less than 35 weeks' gestation, but only 12% had either grade III or grade IV haemorrhages. The prevalence and severity of PV-IVH increased with both decreasing birth weight and decreasing gestational age and was also predicted by the need for active resuscitation at birth, mechanical ventilation and the development of pneumothorax. A total of 93% of infants without PV-IVH survived, but survival decreased with increasing grade of PV-IVH. Germinal matrix cysts were noted on follow-up in 55% of surviving infants with grade I PV-IVH. Very-low-birth-weight infants at Baragwanath Hospital therefore seem to have a higher prevalence of PV-IVH when compared with reported figures, but this is due mainly to an increase in smaller haemorrhages.