Corzo-Pineda J A, Jurado-Hernández V H, Acosta-Rosales A
Pediatra Neonatóloga Unidad de Cuidados Intensivos Neonatales, Hospital de Gineco-Obstetricia Luis Castelazo Ayala I.M.S.S.
Ginecol Obstet Mex. 1997 Nov;65:465-9.
The goal of this article is to know the incidence of early periventricular-intraventricular hemorrhage (EPIVH) and the risk factors that contribute to its development in low birth weight infants of less than 1500 g. Ultrasonographic brain scan was performed in Newborns with perinatal risk factors with birth weight less than 1500 grams, gestational age less than 34 weeks, and extrauterine age less than 24 hours at the time of the brain scan. 91 patients met inclusion criteria, 48 (52.7%) had EPIVH. 27 (29.7%) had periventricular ecodensities and 16 (17.6%) had a normal brain scan. Statistical significative differences were found between group with EPIVH and patients with normal brain scan respect to birth weight, gestational age, and Apgar score at 5 minutes. Perinatal risk factors that were significative to EIVH more than grade I were, premature rupture of membranes, vaginal delivery and Apgar score of 0-2 at 1 minute. The most relevant risk factors to EIVH grade III and cerebral infarction were twin pregnancy, vaginal delivery, breech presentation, obstetric trauma and urinary tract infection. Our incidence of EIVH is according to literature. cesarean section must be considered to diminish neonatal neurological morbidity and mortality.
本文的目的是了解出生体重低于1500g的低体重婴儿早期脑室周围-脑室内出血(EPIVH)的发生率及其发生的危险因素。对有围产期危险因素、出生体重低于1500克、胎龄小于34周且在进行脑部扫描时宫外年龄小于24小时的新生儿进行脑部超声扫描。91例患者符合纳入标准,48例(52.7%)发生EPIVH。27例(29.7%)有脑室周围回声增强,16例(17.6%)脑部扫描正常。在出生体重、胎龄和5分钟时的阿氏评分方面,发生EPIVH的组与脑部扫描正常的患者之间存在统计学显著差异。对I级以上的EIVH有显著意义的围产期危险因素是胎膜早破、阴道分娩和1分钟时阿氏评分为0-2分。对III级EIVH和脑梗死最相关的危险因素是双胎妊娠、阴道分娩、臀位、产科创伤和尿路感染。我们的EIVH发生率与文献相符。必须考虑剖宫产以降低新生儿神经疾病的发病率和死亡率。