Utility of performing routine head ultrasounds in preterm infants with gestational age 3034 weeks
The American Academy of Neurology and Child Neurology Society recommend performing routine screening head ultrasounds (HUS) on preterm infants of less than 30 weeks gestation.
To study the incidence of intraventricular hemorrhage (IVH) and evaluate the need for screening HUS in preterm infants with gestational age (GA) of 30-34 weeks.
Preterm infants (GA; 30-34 weeks) admitted to the neonatal intensive care unit (NICU) between January 1997 and September 2007 were included in this study. Grades of IVH were defined as per the Papile classification.
Screening HUS were performed on 463 infants with GA of 30-34 weeks. Twenty-seven (5.8%) infants had abnormal cranial ultrasound (US) (IVH or periventricular leucomalacia [PVL]). The incidence of IVH ranged from 3.3% to 6.3% at various GA. Seven (1.5%) infants had severe abnormalities on HUS (grades III/IV or PVL).
A significant number of infants born between 30 and 34 weeks of gestation have abnormalities on screening cranial US. Since not all infants born at 30-34 weeks of gestation received a HUS, the incidence of HUS abnormalities might have been overestimated due to a possible 'selection bias'. Additional studies are needed to examine the adverse neurodevelopmental outcomes in this group of preterm infants with mild abnormalities (IVH grades I or II) on cranial US before recommending routine screenings for IVH.
Available from: Vinayak Govande
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It is common clinical practice to counsel parents expecting an early-moderate premature birth. The aim of the current study was to assess maternal knowledge of potential problems of prematurity after counseling.
Prospective study of 49 participants admitted between 23 and 33 weeks gestation with threatened premature birth; a prematurity knowledge questionnaire and the State-Trait Anxiety Inventory were administered after counseling but before delivery.
Across all gestational-ages, participants were more aware of short-term problems than long-term problems. With increasing gestational age the knowledge of long-term problems decreased (P=0.01). Maternal knowledge was 82% for gestational ages where clear guidelines exist regarding goal of counseling and information that should be provided to the parents.
Most mothers of early-moderate premature infants are not aware of the potential for long-term problems. Guidelines, which outline the information that should be provided to parents, may improve maternal knowledge after counseling.
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ABSTRACT: Intraventricular hemorrhage (IVH), herein encompassing germinal matrix and intraventricular and intraparenchymal hemorrhage, is a characteristic lesion of the preterm neonate. The severity of hemorrhage  ranges from germinal matrix hemorrhage (grade 1), where the bleeding is restricted to the subependymal zone of the ventricles, through intraventricular hemorrhage (grade 2 when the blood occupies 50 % of the ventricle and distends it). The most severe form of the IVH grading system is intraparenchymal hemorrhage or periventricular hemorrhagic infarction (PHI or grade 4), which may not have significant hemorrhage into the ventricles.
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