Publication:

A study of clinical profile and outcome of intra ventricular hemorrhage in neonates admitted to neonatal intensive care unit of a tertiary care hospital, Eluru, Andhra Pradesh, India

Background The human hemostatic system is dynamic and is profoundly influenced by age. Although considered immature in the new-born, it is a physiological system which results in few problems for the healthy term neonate, but may contribute to morbidity in the sick and preterm infants when additional acquired abnormalities may be present. The objectives were, the study has been conducted to evaluate the clinical presentation, etiological risk factors of Intraventricular haemorrhage (IVH) and to correlate the birth weight, gestational age, sex, mode of delivery, perinatal factors with the incidence of IVH and to study the immediate outcome.

Methods This is a prospective study which included neonates admitted in the Neonatal intensive care unit (NICU) of Department of Paediatrics, Alluri Sita Rama Raju Medical College, Eluru, Andhra Pradesh, India during the period of March 2013 and September 2014. We enrolled 135 newborns in the study and blood investigations and transcranial USG was done in all.

Results Incidence of IVH in new-borns admitted in NICU at Alluri Sita Rama Raju Medical College was 13.3% (18 out of 135 babies), whereas incidence of IVH in preterm babies was 26.9% (17 out of 63 babies) and incidence of IVH in term babies was 1.3% (1 out of 72 babies). 94.4% of the new-borns with IVH had prolonged prothrombin time (p<0.01). Thrombocytopenia was responsible in 83.4% as an associated risk factor in the development of IVH (p<0.01).

Conclusions Intraventricular Hemorrhage constitutes an important cause of morbidity and mortality in neonate. Need for assisted ventilation irrespective of the co morbidities, presence of metabolic acidosis, have been associated with increased incidence of IVH. Deranged coagulation profile (Thrombocytopenia, prolonged prothrombin time (PT)) have been associated with increased risk for the incidence of IVH in new-borns.