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Periventricular-Intraventricular Hemorrhage in the Full-term Infant

Journal of the Korean Pediatric Society 1994;37(5):642-648.
Published online May 15, 1994.
Periventricular-Intraventricular Hemorrhage in the Full-term Infant
Hee Sup Kim1, Beyong Il Kim1, Jung-Hwan Choi1, Chong Ku Yun1, In One Kim2
1Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
2Department of Radiology, Seoul National University, College of Medicine, Seoul, Korea
1993년에 유행한 무균성 뇌막염 - 바이러스 배양을 중심으로 -
김희섭1, 김병일1, 최중환1, 윤종구1, 김인원2
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 방사선과학교실
Intraventricular hemorrhage (IVH) is common in the premature infants and occurs mainly in subependymal germinal matrix. In contrast, IVH in the term infants is rare and different in pathogenesis and bleeding sites from those of the premature infants. Most studies of IVH in term infants have been studied by computerized tomography and postmortem examination. Brain ultrasonography which has become a frequently used diagnostic tool of IVH in the premature infants is reported to be also effective in diagnosis in the term infants. The study population comprised II term neonates admitted to the Neonatal Intensive Care Unit of Seoul National University Children's Hospital between July 1989 and jUne 1991, in whom IVH was diagnosed by ultrasongraphy. We analysed severity of birth asphyxia, ultrasonographic findings and clinical manifestations to investigate severity, timing, risk factors, and pathogenesis of IVH in the term neonates. 1) Apgar scores were available in 7 cases: 4 cases with severe asphyxia(Apgar at 1 min: less than 3), 1 cases with mild asphyxia(Apgar at 1 min: between 5~7), and 2 cases without asphyxia. 2) Clinically, 4 cases had fetal distress, and 3 cases had meconium aspiration pneumonia. 3) bleeding sites by ultrasonography were subependymal germinal matrix in all II cases. IVH of choroid plexus was compined in 2 cases. Severity of IVH were grade 1 in 9 cases, grade II in cases by Papile's classification. 4) There were no correlations between the grade of IVH and severity of perinatal asphyxia. In conclusion, ultrasonography is very useful in diagnosis and follow-up of IVH in term neonates. Subependymal germinal matrix could be common site of IVH in term neonates because germinal matrix still remains in term neonates despite of its regression. Also this can explain why IVH in our cases is not severe.
Key Words: Intraventricular hemorrhage, Term-neonate

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