Intraventricular haemorrhage in premature infants. Review of diagnostic methods, treatment and influence on neurodevelopment

Abstract

Introduction: Preterm infants are at high risk for various neurological complications and mortality caused by hypoxemia, haemorrhage or inflammation concerning preterm delivery. Resulting brain lesions are mostly asymptomatic - they cannot be diagnosed clinically as such neuroimaging of preterm infants has become part of routine clinical care.

In this article, newest studies about intraventricular haemorrhage, its complications and treatment methods were reviewed. The PubMed database was searched using keywords “intraventricular haemorrhage”, “preterm infant”, “intraventricular haemorrhage treatment”, “intraventricular haemorrhage outcome”. 

State of knowledge: Early diagnosis, appropriate nursing care and treatment can minimise morbidity. Prognosis is mainly determined by the severity of bleeding, occurred complications and neurological irreversible changes. Intraventricular haemorrhage can cause posthemorrhagic hydrocephalus, cerebral palsy, disability and mental retardation in further life. Even mild grades of haemorrhage can result in developmental disorders. Long-term issues such as neurodevelopmental disorders and cerebral palsy are as important as short-term problems. Detection of injuries affecting preterm infants is used to identify complications that might necessitate an intervention. While head ultrasound is the standard of care for routine neuroimaging screening, the use of brain magnetic resonance imaging has expanded recently.

Conclusions: Considerable advances in neonatal care have resulted in improved survival and prognosis of development of preterm infants with intraventricular haemorrhage. Although there is a wide range of treatment methods, further studies are needed to assess their safety, effectiveness and impact on short- and long-term outcome.