Retrospective evaluation of newborns with germinal matrix hemorrhage after preterm delivery
Year 2023,
Volume: 9 Issue: 3, 249 - 256, 31.12.2023
Ali Özen
,
Selahattin Akar
Abstract
Aim: This study aimed to evaluate the clinical course and treatment results of patients with germinal matrix hemorrhage.
Materials and Methods: Patients who have germinal matrix hemorrhage, between January 2018 and March 2020 were retrospectively analysed.
Results: A total of 66 patients were followed up due to germinal matrix hemorrhage. Thirty-four of the patients were girls and 32 were boys. Eighteen patients had stage-1, 22 stage-2, 16 stage-3 and 10 stage-4 hemorrhages. Ventricular tap was performed in 26 patients. External ventricular drainage was used in 13 patients. Ventricular reservoir, and ventriculosubgaleal shunt were used in one patient each. Eight patients underwent ventriculoperitoneal shunt surgery. Thirty-six patients died. Twenty-five patients were discharged. Five patients were referred to an external center.
Conclusions: Germinal matrix hemorrhages are common after preterm delivery and may be asymptomatic. Evaluation of these patients with transfontanel ultrasonography provides the opportunity for early diagnosis and treatment. There is no common algorithm for the treatment of these patients yet.
Ethical Statement
Araştırmanın etik açıdan uygunluğu için Adıyaman Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan 15.11.2022 tarihinde 2022/8-10 karar sayısı ile etik onay alınmıştır. Araştırma süreci Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.
Supporting Institution
Çalışmayı maddi olarak destekleyen kişi/kuruluş yoktur.
Thanks
Çalışmaya dahil edilen hastaların takip ve tedavisine dahil olan tüm sağlık çalışanlarına teşekkür ederiz.
References
- Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-2172. doi:10.1016/S0140-6736(12)60820-4
- Perin J, Mulick A, Yeung D, et al. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health. 2022;6(2):106-115. doi:10.1016/S2352-4642(21)00311-4
- Purisch SE, Gyamfi-Bannerman C. Epidemiology of preterm birth. Semin Perinatol. 2017;41(7):387-391. doi:10.1053/J.SEMPERI.2017.07.009
- Kim HM, Kim KH. Clinical Experience of Infantile Posthemorrhagic Hydrocephalus Treated with Ventriculo-Peritoneal Shunt. Korean J Neurotrauma. 2015;11(2):106. doi:10.13004/KJNT.2015.11.2.106
- Synnes AR, Chien LY, Peliowski A, Baboolal R, Lee, SK. Variations in intraventricular hemorrhage incidence rates among Canadian neonatal intensive care units. J Pediatr. 2001;138(4):525-531. doi:10.1067/MPD.2001.111822
- Lee JY, Kim HS, Jung E, et al. Risk factors for periventricular-intraventricular hemorrhage in premature infants. J Korean Med Sci. 2010;25(3):418-424. doi:10.3346/JKMS.2010.25.3.418
- Khodapanahandeh F, Khosravi N, Larijani T. Risk factors for intraventricular hemorrhage in very low birth weight infants in Tehran, Iran. Turk J Pediatr. 2008;50:247-252.
- Khan IA, Wahab S, Khan RA, Ullah E, Ali M. Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning. J Korean Neurosurg Soc. 2010;47(2):89-94. doi:10.3340/JKNS.2010.47.2.89
- Papile LA, Munsick-Bruno G, Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J Pediatr. 1983;103(2):273-277. doi:10.1016/S0022-3476(83)80366-7
- Levene MI, Starte DR. A longitudinal study of post-haemorrhagic ventricular dilatation in the newborn. Arch Dis Child. 1981;56(12):905-910. doi:10.1136/ADC.56.12.905
- Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92(4):529-534. doi:10.1016/S0022-3476(78)80282-0
- Bowerman RA, Donn SM, Silver TM, Jaffe MH. Natural history of neonatal periventricular/intraventricular hemorrhage and its complications: sonographic observations. AJR Am J Roentgenol. 1984;143(5):1041-1052. doi:10.2214/AJR.143.5.1041
- Brouwer AJ, Groenendaal F, Benders MJNL, De Vries LS. Early and late complications of germinal matrix-intraventricular haemorrhage in the preterm infant: what is new? Neonatology. 2014;106(4):296-303. doi:10.1159/000365127
- Novak CM, Ozen M, Burd I. Perinatal Brain Injury: Mechanisms, Prevention, and Outcomes. Clin Perinatol. 2018;45(2):357-375. doi:10.1016/J.CLP.2018.01.015
- Luo J, Luo Y, Zeng H, Reis C, Chen S. Research Advances of Germinal Matrix Hemorrhage: An Update Review. Cell Mol Neurobiol. 2019;39(1). doi:10.1007/S10571-018-0630-5
- Bassan H. Intracranial Hemorrhage in the Preterm Infant: Understanding It, Preventing It. Clin Perinatol. 2009;36(4):737-762. doi:10.1016/J.CLP.2009.07.014
- Sauve R. Routine screening cranial ultrasound examinations for the prediction of long term neurodevelopmental outcomes in preterm infants. Paediatr Child Health. 2001;6(1). doi:10.1093/PCH/6.1.39
- Armstrong DL, Sauls CD, Goddard-Finegold J. Neuropathologic findings in short-term survivors of intraventricular hemorrhage. Am J Dis Child. 1987;141(6):617-621. doi:10.1001/ARCHPEDI.1987.04460060035027
- Whitelaw A, Aquilina K. Management of posthaemorrhagic ventricular dilatation. Arch Dis Child Fetal Neonatal Ed. 2012;97(3). doi:10.1136/ADC.2010.190173
- Levene MI. Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. Arch Dis Child. 1981;56(12):900-904. doi:10.1136/ADC.56.12.900
- Davies MW, Swaminathan M, Chuang SL, Betheras FR. Reference ranges for the linear dimensions of the intracranial ventricles in preterm neonates. Arch Dis Child Fetal Neonatal Ed. 2000;82(3). doi:10.1136/FN.82.3.F218
- Whitelaw A. Repeated lumbar or ventricular punctures in newborns with intraventricular hemorrhage. Cochrane Database Syst Rev. 2001;(1). doi:10.1002/14651858.CD000216
- Berger A, Weninger M, Reinprecht A, Haschke N, Kohlhauser C, Pollak A. Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants. Childs Nerv Syst. 2000;16(2):103-109. doi:10.1007/S003810050022
- Limbrick DD, Mathur A, Johnston JM, et al. Neurosurgical treatment of progressive posthemorrhagic ventricular dilation in preterm infants: a 10-year single-institution study. J Neurosurg Pediatr. 2010;6(3):224-230. doi:10.3171/2010.5.PEDS1010
- Lam HP, Heilman CB. Ventricular access device versus ventriculosubgaleal shunt in post hemorrhagic hydrocephalus associated with prematurity. J Matern Fetal Neonatal Med. 2009;22(11):1097-1101. doi:10.3109/14767050903029576
- Köksal V, Öktem S. Ventriculosubgaleal shunt procedure and its long-term outcomes in premature infants with post-hemorrhagic hydrocephalus. Childs Nerv Syst. 2010;26(11):1505-1515. doi:10.1007/S00381-010-1118-X
- Bot G, Constantini S, Roth J. Intraventricular migration of ventricular access device. Childs Nerv Syst. 2013;29(11):1975-1976. doi:10.1007/S00381-013-2292-4
- Hudgins RJ, Boydston WR, Gilreath CL. Treatment of Posthemorrhagic Hydrocephalus in the Preterm Infant with a Ventricular Access Device. Pediatr Neurosurg. 1998;29(6):309-313. doi:10.1159/000028744
- Adams-Chapman I, Hansen NI, Stoll BJ, Higgins R. Neurodevelopmental outcome of extremely low birth weight infants with posthemorrhagic hydrocephalus requiring shunt insertion. Pediatrics. 2008;121(5). doi:10.1542/PEDS.2007-0423
- Taylor AG, Peter JC. Advantages of delayed VP shunting in post-haemorrhagic hydrocephalus seen in low-birth-weight infants. Childs Nerv Syst. 2001;17(6):328-333. doi:10.1007/S003810000429
Preterm doğum sonrası germinal matriks kanaması olan yenidoğanların retrospektif değerlendirilmesi
Year 2023,
Volume: 9 Issue: 3, 249 - 256, 31.12.2023
Ali Özen
,
Selahattin Akar
Abstract
Amaç: Bu çalışmada germinal matriks kanaması olan hastaların klinik seyri ve tedavi sonuçlarını değerlendirmek amaçlanmıştır.
Gereç ve Yöntem: Ocak 2018 – Mart 2020 tarihleri arasında germinal matriks kanaması olan hastalar retrospektif olarak incelenmiştir.
Bulgular: Toplam 66 hasta germinal matriks kanaması nedeni ile takip edildi. Hastaların 34’ü kadın, 32’si erkekti. On sekiz hastanın evre-1, 22 hastanın evre-2, 16 hastanın evre-3 ve 10 hastanın evre-4 kanaması vardı. Yirmi altı hastaya ventriküler tap yapıldı. On üç hastaya eksternal ventriküler drenaj takıldı. Bir hastaya ventriküler rezervuar ve bir hastaya ventrikülosubgaleal şant takıldı. Takiplerinde sekiz hastaya ventriküloperitoneal şant takıldı. Otuz altı hasta exitus oldu. Yirmi beş hasta taburcu edildi. Beş hasta dış merkeze sevk edildi.
Sonuç: Preterm doğum sonrası germinal matriks kanamaları sık görülmekte ve asemptomatik olabilmektedir. Hastaların transfontanel ultrasonografi ile değerlendirilmeleri erken tanı ve tedavi olanağı sağlamaktadır. Bu hastaların tedavileri konusunda ortak bir algoritma henüz bulunmamaktadır.
Ethical Statement
Araştırmanın etik açıdan uygunluğu için Adıyaman Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan 15.11.2022 tarihinde 2022/8-10 karar sayısı ile etik onay alınmıştır. Araştırma süreci Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.
Supporting Institution
Çalışmayı maddi olarak destekleyen kişi/kuruluş yoktur.
Thanks
Çalışmaya dahil edilen hastaların takip ve tedavisine dahil olan tüm sağlık çalışanlarına teşekkür ederiz.
References
- Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-2172. doi:10.1016/S0140-6736(12)60820-4
- Perin J, Mulick A, Yeung D, et al. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health. 2022;6(2):106-115. doi:10.1016/S2352-4642(21)00311-4
- Purisch SE, Gyamfi-Bannerman C. Epidemiology of preterm birth. Semin Perinatol. 2017;41(7):387-391. doi:10.1053/J.SEMPERI.2017.07.009
- Kim HM, Kim KH. Clinical Experience of Infantile Posthemorrhagic Hydrocephalus Treated with Ventriculo-Peritoneal Shunt. Korean J Neurotrauma. 2015;11(2):106. doi:10.13004/KJNT.2015.11.2.106
- Synnes AR, Chien LY, Peliowski A, Baboolal R, Lee, SK. Variations in intraventricular hemorrhage incidence rates among Canadian neonatal intensive care units. J Pediatr. 2001;138(4):525-531. doi:10.1067/MPD.2001.111822
- Lee JY, Kim HS, Jung E, et al. Risk factors for periventricular-intraventricular hemorrhage in premature infants. J Korean Med Sci. 2010;25(3):418-424. doi:10.3346/JKMS.2010.25.3.418
- Khodapanahandeh F, Khosravi N, Larijani T. Risk factors for intraventricular hemorrhage in very low birth weight infants in Tehran, Iran. Turk J Pediatr. 2008;50:247-252.
- Khan IA, Wahab S, Khan RA, Ullah E, Ali M. Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning. J Korean Neurosurg Soc. 2010;47(2):89-94. doi:10.3340/JKNS.2010.47.2.89
- Papile LA, Munsick-Bruno G, Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J Pediatr. 1983;103(2):273-277. doi:10.1016/S0022-3476(83)80366-7
- Levene MI, Starte DR. A longitudinal study of post-haemorrhagic ventricular dilatation in the newborn. Arch Dis Child. 1981;56(12):905-910. doi:10.1136/ADC.56.12.905
- Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92(4):529-534. doi:10.1016/S0022-3476(78)80282-0
- Bowerman RA, Donn SM, Silver TM, Jaffe MH. Natural history of neonatal periventricular/intraventricular hemorrhage and its complications: sonographic observations. AJR Am J Roentgenol. 1984;143(5):1041-1052. doi:10.2214/AJR.143.5.1041
- Brouwer AJ, Groenendaal F, Benders MJNL, De Vries LS. Early and late complications of germinal matrix-intraventricular haemorrhage in the preterm infant: what is new? Neonatology. 2014;106(4):296-303. doi:10.1159/000365127
- Novak CM, Ozen M, Burd I. Perinatal Brain Injury: Mechanisms, Prevention, and Outcomes. Clin Perinatol. 2018;45(2):357-375. doi:10.1016/J.CLP.2018.01.015
- Luo J, Luo Y, Zeng H, Reis C, Chen S. Research Advances of Germinal Matrix Hemorrhage: An Update Review. Cell Mol Neurobiol. 2019;39(1). doi:10.1007/S10571-018-0630-5
- Bassan H. Intracranial Hemorrhage in the Preterm Infant: Understanding It, Preventing It. Clin Perinatol. 2009;36(4):737-762. doi:10.1016/J.CLP.2009.07.014
- Sauve R. Routine screening cranial ultrasound examinations for the prediction of long term neurodevelopmental outcomes in preterm infants. Paediatr Child Health. 2001;6(1). doi:10.1093/PCH/6.1.39
- Armstrong DL, Sauls CD, Goddard-Finegold J. Neuropathologic findings in short-term survivors of intraventricular hemorrhage. Am J Dis Child. 1987;141(6):617-621. doi:10.1001/ARCHPEDI.1987.04460060035027
- Whitelaw A, Aquilina K. Management of posthaemorrhagic ventricular dilatation. Arch Dis Child Fetal Neonatal Ed. 2012;97(3). doi:10.1136/ADC.2010.190173
- Levene MI. Measurement of the growth of the lateral ventricles in preterm infants with real-time ultrasound. Arch Dis Child. 1981;56(12):900-904. doi:10.1136/ADC.56.12.900
- Davies MW, Swaminathan M, Chuang SL, Betheras FR. Reference ranges for the linear dimensions of the intracranial ventricles in preterm neonates. Arch Dis Child Fetal Neonatal Ed. 2000;82(3). doi:10.1136/FN.82.3.F218
- Whitelaw A. Repeated lumbar or ventricular punctures in newborns with intraventricular hemorrhage. Cochrane Database Syst Rev. 2001;(1). doi:10.1002/14651858.CD000216
- Berger A, Weninger M, Reinprecht A, Haschke N, Kohlhauser C, Pollak A. Long-term experience with subcutaneously tunneled external ventricular drainage in preterm infants. Childs Nerv Syst. 2000;16(2):103-109. doi:10.1007/S003810050022
- Limbrick DD, Mathur A, Johnston JM, et al. Neurosurgical treatment of progressive posthemorrhagic ventricular dilation in preterm infants: a 10-year single-institution study. J Neurosurg Pediatr. 2010;6(3):224-230. doi:10.3171/2010.5.PEDS1010
- Lam HP, Heilman CB. Ventricular access device versus ventriculosubgaleal shunt in post hemorrhagic hydrocephalus associated with prematurity. J Matern Fetal Neonatal Med. 2009;22(11):1097-1101. doi:10.3109/14767050903029576
- Köksal V, Öktem S. Ventriculosubgaleal shunt procedure and its long-term outcomes in premature infants with post-hemorrhagic hydrocephalus. Childs Nerv Syst. 2010;26(11):1505-1515. doi:10.1007/S00381-010-1118-X
- Bot G, Constantini S, Roth J. Intraventricular migration of ventricular access device. Childs Nerv Syst. 2013;29(11):1975-1976. doi:10.1007/S00381-013-2292-4
- Hudgins RJ, Boydston WR, Gilreath CL. Treatment of Posthemorrhagic Hydrocephalus in the Preterm Infant with a Ventricular Access Device. Pediatr Neurosurg. 1998;29(6):309-313. doi:10.1159/000028744
- Adams-Chapman I, Hansen NI, Stoll BJ, Higgins R. Neurodevelopmental outcome of extremely low birth weight infants with posthemorrhagic hydrocephalus requiring shunt insertion. Pediatrics. 2008;121(5). doi:10.1542/PEDS.2007-0423
- Taylor AG, Peter JC. Advantages of delayed VP shunting in post-haemorrhagic hydrocephalus seen in low-birth-weight infants. Childs Nerv Syst. 2001;17(6):328-333. doi:10.1007/S003810000429