Article
Premature infants with less than 1500g of birth weight – incidence of intraventricular haemorrhage and hydrocephalus – a single institute analysis
Frühgeborene unter 1500g – Inzidenz von Ventrikelblutung und posthämorrhagischem Hydrozephalus – eine Einzel-Institutsanalyse
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Authors
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Elke Januschek
- Sana Klinikum Offenbach GmbH, Neurochirurgische Klinik und Ambulanz, Offenbach, Deutschland; Asklepios Kinderkrankenhaus, Kinderneurochirurgie, Sankt Augustin, Deutschland
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Nina Evertz
- Asklepios Kinderkrankenhaus, Kinderneurochirurgie, Sankt Augustin, Deutschland
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Stephanie Jünger
- Asklepios Kinderkrankenhaus, Kinderneurochirurgie, Sankt Augustin, Deutschland
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Andreas Röhrig
- Asklepios Kinderkrankenhaus, Kinderneurochirurgie, Sankt Augustin, Deutschland
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Sandra Kunze
- Asklepios Kinderkrankenhaus, Kinderneurochirurgie, Sankt Augustin, Deutschland
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Christian Fremerey
- Asklepios Kinderkrankenhaus, Neonatologie, Sankt Augustin, Deutschland
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Bea Wiebe
- Asklepios Kinderkrankenhaus, Neonatologie, Sankt Augustin, Deutschland
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Martina Messing-Jünger
- Asklepios Kinderkrankenhaus, Kinderneurochirurgie, Sankt Augustin, Deutschland
| Published: | May 8, 2019 |
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Outline
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Objective: With changed treatment concepts in neonatology the mortality and occurrence of intraventricular hemorrhage (IVH) in premature babies could be lowered. The incidence of IVH in very low birthweight infants (VLBW <1500g) varies in the literature between 20% (Murphy 2002) and 61% (Sajjadian 2009). The aim of our study was to analyze the incidence of IVH, hydrocephalus (HC) and shunt dependency in our institution.
Methods: We retrospectively analyzed all preterms equal or less than 1500g, which were born in the years 2011 to 2015 in the children’s hospital. In addition to birth weight the occurrence of cerebral hemorrhages and/or ventricular dilatation were investigated as well as the frequency of shunt dependency.
Results: 170 VLBW infants (89 males, 81 females) were included. The lowest birth weight was 360g and on average 1119g. In 153 cases a cesarean section was required, 53 times it was a multiple pregnancy. The overall mortality was 3%. Brain sonography was done routineously and showed an IVH in 35 cases (20.6%). Twelve children developed unilateral hemorrhage, in 23 cases the bleeding occurred bilaterally. A moderate to severe IVH was observed in 7% and a mild IVH (grade 1–2) in 13.5%. A reservoir was required in 10 cases (5.9%). All these children (8 males, 2 females) developed shunt dependency. A nonadjustable valve with integrated gravitational unit was implanted in 90% and once an adjustable valve without gravitational unit. In 50% initially an antibiotic coated catheter was used. The follow up time ranged between two (homeland-related further treatment) and 60 months. No mortality and no intraoperative complications occurred in this high risk group. One children did not require revision in the follow up period, one revision was necessary in 4 cases, the others had 2 to 3 revision surgeries. Seizures were observed in 2 children, all children are statometically retarded in varying degrees.
Conclusion: In the high risk VLBW group the mortality rate was low with 3%. Compared to the literature, the rate of hemorrhage is in the lower range at 20.6%. Only 5.9% became shunt-dependent during the course. Unfortunately, all children are lagging behind.
