Ghalia Al Yazidi1, Myriam Srour1, Pia Wintermark2. 1. Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. 2. Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: pia.wintermark@bluemail.ch.
Abstract
BACKGROUND: Intraventricular hemorrhage is rare in term newborns. Severe asphyxia is recognized as one of the risk factors of intraventricular hemorrhage in these newborns. Therapeutic hypothermia, which is the only available treatment for the limitation of brain injury in term asphyxiated newborns, may cause fluctuations of cerebral blood flow, possibly placing the newborn more at risk for intraventricular hemorrhage. The literature regarding the incidence of intraventricular hemorrhage in the context of neonatal hypoxic-ischemic encephalopathy and hypothermia is sparse. METHODS: We present a clinical observation and review the literature regarding the risk factors for intraventricular hemorrhage in term asphyxiated newborns treated with hypothermia. RESULTS: We describe the clinical course of a term newborn with severe hypoxic-ischemic encephalopathy who developed significant intraventricular hemorrhage during the rewarming period after the 72-hour hypothermia. CONCLUSION: This newborn presented several risk factors for intraventricular hemorrhage, including severe asphyxia, hemodynamic instability, hemostasis disturbances, instrument delivery, venous sinus thrombosis, and hypoglycemia. Hypothermia and rewarming also may have contributed by causing fluctuations in cerebral blood flow.
BACKGROUND: Intraventricular hemorrhage is rare in term newborns. Severe asphyxia is recognized as one of the risk factors of intraventricular hemorrhage in these newborns. Therapeutic hypothermia, which is the only available treatment for the limitation of brain injury in term asphyxiated newborns, may cause fluctuations of cerebral blood flow, possibly placing the newborn more at risk for intraventricular hemorrhage. The literature regarding the incidence of intraventricular hemorrhage in the context of neonatal hypoxic-ischemicencephalopathy and hypothermia is sparse. METHODS: We present a clinical observation and review the literature regarding the risk factors for intraventricular hemorrhage in term asphyxiated newborns treated with hypothermia. RESULTS: We describe the clinical course of a term newborn with severe hypoxic-ischemicencephalopathy who developed significant intraventricular hemorrhage during the rewarming period after the 72-hour hypothermia. CONCLUSION: This newborn presented several risk factors for intraventricular hemorrhage, including severe asphyxia, hemodynamic instability, hemostasis disturbances, instrument delivery, venous sinus thrombosis, and hypoglycemia. Hypothermia and rewarming also may have contributed by causing fluctuations in cerebral blood flow.
Authors: Bogdan Mihai Neamțu; Gabriela Visa; Ionela Maniu; Maria Livia Ognean; Rubén Pérez-Elvira; Andrei Dragomir; Maria Agudo; Ciprian Radu Șofariu; Mihaela Gheonea; Antoniu Pitic; Remus Brad; Claudiu Matei; Minodora Teodoru; Ciprian Băcilă Journal: Int J Environ Res Public Health Date: 2021-04-30 Impact factor: 3.390