INTRAVENTRICULAR HAEMORRHAGE IN NEWBORNS: AETIOLOGY, DIAGNOSIS, AND MODERN APPROACHES TO MANAGEMENT
Keywords:
KEY WORDS:Intraventricular Haemorrhage, Germinal Matrix, Preterm Infant, Posthaemorrhagic Hydrocephalus, Cranial Ultrasonography, Neurodevelopmental Outcome, Neonate.Abstract
ABSTRACT
Intraventricular haemorrhage (IVH) is a severe neurological complication,
predominantly affecting preterm infants, and remains a leading cause of morbidity and
mortality in neonatology. Its pathogenesis is closely linked to the intrinsic vulnerability
of the germinal matrix and impaired cerebral autoregulation in premature
infants. This review aims to synthesise current knowledge on the epidemiology, risk
factors, pathophysiology, diagnostic methods, and therapeutic strategies for IVH, with
a focus on preventive measures. The incidence of IVH is inversely proportional to
gestational age and birth weight, with the highest risk observed in infants born before
28 weeks of gestation. The primary pathogenetic mechanisms include capillary
fragility in the germinal matrix, fluctuations in cerebral blood flow, and coagulation
disorders. The gold standard for diagnosis is cranial ultrasonography through the
anterior fontanelle. Modern management is primarily supportive and preventive. Key
preventive strategies include antenatal corticosteroid therapy, delayed umbilical cord
clamping, and meticulous postnatal stabilisation of haemodynamic parameters. The
management of posthaemorrhagic hydrocephalus (PHH), the most common
complication of severe IVH, remains a significant challenge and may require surgical
intervention. Despite advances in perinatal medicine, IVH continues to be a major
cause of adverse neurodevelopmental outcomes. The prognosis directly correlates with
the severity of the haemorrhage. Future research should be directed towards
developing neuroprotective strategies and optimising methods for the management of
PHH.
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