Intraventricular hemorrhage in the premature infant. A changing outlook

Shlomo Shinnar, R. A. Molteni, K. Gammon, B. J. D'Souza, J. Altman, J. M. Freeman

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Over the past decade morbidity and mortality among very-low-birth-weight preterm infants decreased dramatically. With improved survival, a previously rare diagnosis - intraventricular hemorrhage - became increasingly common. Introduction of the CT scanner revealed that 32 to 44% of infants weighing under 1500 g at birth had subependymal hemorrhage or intraventricular hemorrhage. Routine scanning of infants weighing under 1800 g became common. The mortality from severe hemorrhage was estimated to be 50 to 65%, and hydrocephalus was believed to develop in 45 to 100% of the survivors. Various medical approaches to the therapy of posthemorrhagic hydrocephalus were tried in an effort to avoid the problems associated with surgical shunting. Accordingly, we designed a prospective, randomized study of the efficacy of prophylactic treatment of posthemorrhagic hydrocephalus by serial lumbar punctures, acetazolamide, and furosemide. As part of the study, all infants in our nursery who weighed 1800 g at birth were screened for intraventricular hemorrhage in order to select appropriate candidates for prophylactic therapy. After 11 months, review of 115 consecutive infants who survived the first 24 hours of life revealed an incidence of subependymal and intraventricular hemorrhage of 35% (40 infants), as anticipated, but fewer cases of intraventricular extension (16 of these 40) and a lower mean gestational age (28.9 weeks) in infants with hemorrhage than in previous reports.

Original languageEnglish (US)
Pages (from-to)1464-1468
Number of pages5
JournalNew England Journal of Medicine
Volume306
Issue number24
StatePublished - 1982
Externally publishedYes

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Premature Infants
Hemorrhage
Hydrocephalus
Parturition
Very Low Birth Weight Infant
Acetazolamide
Spinal Puncture
Mortality
Nurseries
Furosemide
Gestational Age
Survivors
Prospective Studies
Morbidity
Survival
Incidence
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Shinnar, S., Molteni, R. A., Gammon, K., D'Souza, B. J., Altman, J., & Freeman, J. M. (1982). Intraventricular hemorrhage in the premature infant. A changing outlook. New England Journal of Medicine, 306(24), 1464-1468.

Intraventricular hemorrhage in the premature infant. A changing outlook. / Shinnar, Shlomo; Molteni, R. A.; Gammon, K.; D'Souza, B. J.; Altman, J.; Freeman, J. M.

In: New England Journal of Medicine, Vol. 306, No. 24, 1982, p. 1464-1468.

Research output: Contribution to journalArticle

Shinnar, S, Molteni, RA, Gammon, K, D'Souza, BJ, Altman, J & Freeman, JM 1982, 'Intraventricular hemorrhage in the premature infant. A changing outlook', New England Journal of Medicine, vol. 306, no. 24, pp. 1464-1468.
Shinnar S, Molteni RA, Gammon K, D'Souza BJ, Altman J, Freeman JM. Intraventricular hemorrhage in the premature infant. A changing outlook. New England Journal of Medicine. 1982;306(24):1464-1468.
Shinnar, Shlomo ; Molteni, R. A. ; Gammon, K. ; D'Souza, B. J. ; Altman, J. ; Freeman, J. M. / Intraventricular hemorrhage in the premature infant. A changing outlook. In: New England Journal of Medicine. 1982 ; Vol. 306, No. 24. pp. 1464-1468.
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