Transontanelar ultrasound in the early diagnosis of intraventricular hemorrhage in the preterm newborn

Abstract

Introduction: intraventricular hemorrhage is one of the most serious complications that occur in the premature newborn.

Objective: to characterize from the maternal-fetal and perinatal point of view the preterm infants –whether or not they are high risk– from the transontanelar echocardiography as an early diagnosis of intraventricular hemorrhage.

Method: a cross-sectional descriptive observational study was carried out at the General Provincial Teaching Hospital of Ciego de Ávila in the period September/2015 to March/2017. The universe was made up of the 218 preterm newborn children treated in the Neonatology Service. The established ethical precepts were fulfilled.

Results: 8,30 % presented ultrasound findings of intraventricular hemorrhage, with a predominance of infants with a lower gestational age. In general, those born with 2 000 g or more (61,93 %) predominated; of them, 16,67 % presented intraventricular hemorrhage. Of these, 38,89 % weighed at birth 1 000-1 499 g, five infants born between 27 and 29,6 weeks were more serious, 64,68 % were products of eutocic births, 27,06 % were mechanically ventilated, 55,65 % had pulmonary hypertension and hypercapnia, 44,44 % hyaline membrane, 27,78 % pneumothorax and 33,3 % had no clinical signs. However, 22,50 % of infants without intraventricular hemorrhage were ventilated and 19,50 % presented clinical manifestations.

Conclusions: the importance of transfontanelar ultrasound was evidenced for the early diagnosis of intraventricular hemorrhage in preterm infants born between 32 and 36,6 weeks of gestation, not included in the high-risk group.