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The use of clinical examination and cranial ultrasound in the diagnosis and management of post-hemorrhagic ventricular dilation in extremely premature infants

Journal of Perinatology volume 38, pages 374–380 (2018)Cite this article

Subjects

Abstract

Objectives

The objective of this study is to describe clinical and ultrasound changes in a cohort of premature newborns with post-hemorrhagic ventricular dilation (PHVD), and to correlate these changes with outcome.

Study Design

Premature newborns <29 weeks gestational age (GA) and ≤ 1,500 g birth weight with intraventricular hemorrhage were retrospectively reviewed. Clinical signs and cranial ultrasound (CUS) findings between time after birth and time before first cerebrospinal fluid temporizing intervention were compared with GA-equivalent newborns without interventions. White matter injury was assessed on brain magnetic resonance imaging.

Results

Between 2011 and 2014, 64 newborns met inclusion criteria; 23% had PHVD. The growth rates of the ventricles on CUS and the head circumference (HC) were higher in newborns with PHVD (p < 0.01 and p = 0.04, respectively) and correlated inversely with white matter injury (p = 0.006 and p < 0.001, respectively).

Conclusion

Progression of PHVD in premature newborns as demonstrated by CUS and the HC correlated with outcome. Consistent measurement of these simple parameters will allow for much needed treatment comparisons, to define optimal protocols that decrease the risk of cerebral palsy in extremely preterm populations.

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Funding

Funding

This work was supported by a grant from the Board of Visitors of Children’s National for the establishment of a Cerebral Palsy Prevention Program.

Author information

Authors and Affiliations

  1. Department of Neurology, Nemours/ A. I. duPont Hospital for Children, Washington, DE, USA

    Rawad Obeid

  2. Department of Neurology, Children’s National Health System, Washington, DC, USA

    Taeun Chang

  3. Department of Fetal Medicine, Children’s National Health System, Washington, DC, USA

    Eresha Bluth & Anna Penn

  4. Center of Neuroscience Research, Children’s National Health System, Washington, DC, USA

    Eresha Bluth, Caitlin Forsythe & Anna Penn

  5. Department of Neonatology, Children’s National Health System, Washington, DC, USA

    Caitlin Forsythe & Anna Penn

  6. Children’s Research Institute, Children’s National Health System, Washington, DC, USA

    Marni Jacobs

  7. Department of Radiology, Children’s National Health System, Washington, DC, USA

    Dorothy Bulas

  8. Department of Neurosurgery, Children’s National Health System, Washington, DC, USA

    Chima Oluigbo

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  1. Rawad Obeid
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Correspondence to Rawad Obeid.

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Disclosures: The authors declare no conflicts of interest.

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Obeid, R., Chang, T., Bluth, E. et al. The use of clinical examination and cranial ultrasound in the diagnosis and management of post-hemorrhagic ventricular dilation in extremely premature infants. J Perinatol 38, 374–380 (2018). https://doi.org/10.1038/s41372-017-0017-3

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