DOI: 10.36347/sjams.2016.v04i04.037

Pages: 1297-1301

The objective of this paper was to study various maternal and neonatal factors in relation to germinal matrix hemorrhage in preterm neonates. It was a hospital based observational study. The subjects included 120 preterm neonates with ≤34 weeks gestation with birth weight between 500 gm to 1500 gm admitted in Neonatal Intensive Care Unit of SDMH Hospital. Various maternal and neonatal risk factors associated with Germinal Matrix – Intraventricular Ventricular Hemorrhage like antenatal complications of pregnancy, prenatal steroids, gestational age, birth weight, hypercapnea, Patent Ductus Arteriosus, pneumothorax etc. were recorded. Routine Cranial Ultrasound was performed within 3 to 5 days of life. The normality of factors was checked using Shapiro–Wilks test and it was found non-normal. Hence, the non parametric correlation coefficient was found using Kendall’s Tau. The level of significance was taken as 0.05 and 0.01. The significant positive correlation was observed between IVH and various factors like non-institutional deliveries, Mechanical ventilation, hypoglycemia, rapid bicarbonate infusion and hypercapnea. The significant negative correlation was observed with antenatal steroids and number of steroid doses, gestational age, birth weight, APGAR Score at 1 minute and 5 minutes, blood pH and paO2. Early intervention to prevent GM-IVH in preterm newborns include Institutional delivery, antenatal steroid, optimal management of labor and delivery, careful newborn resuscitation, prevention of respiratory distress syndrome, correction of fluctuating cerebral flow velocity in the ventilated premature neonates with RDS, early detection and prevention of mild degrees of hypercapnea, hypoxemia, acidosis and correction of acidosis with slow infusion of sodium bicarbonate. Routine CUS should be performed as a screening test for early detection of IVH in premature neonates.