Prevention of intraventricular hemorrhage in the premature infant.
PIVH remains a significant problem in the care of the preterm infant. Recent technologic advances such as real-time ultrasonography and Doppler flow studies have facilitated accurate diagnosis and provided insight into the pathogenesis. Although the overall incidence of PIVH is declining, the outcome of survivors of PIVH--especially those with more severe grades--remains unfavorable. Several antenatal and postnatal interventions aimed at reducing the overall incidence and severity of PIVH have been attempted. Antenatal interventions, in particular phenobarbital, appear to be promising because a substantial percentage of PIVH occurs in the immediate perinatal period. It is significant that the four reported antenatal phenobarbital trials demonstrated a consistent decrease in severe PIVH. Despite the fact that these studies have different designs and each must be considered on its own, the consistency of results makes a strong statement regarding efficacy and safety. The on-going multicenter Neonatal Network trial should provide definitive results as to the efficacy and safety of antenatal phenobarbital in the prevention of PIVH.
Abdel-Rahman
A M
AM
Department of Pediatrics, University of Colorado School of Medicine, Denver.
Rosenberg
A A
AA
D000818:Animals; D002543:Cerebral Hemorrhage / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D002552:Cerebral Ventricles; D002986:Clinical Trials as Topic; D005315:Fetal Diseases / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D015337:Multicenter Studies as Topic; D010634:Phenobarbital / Q000627:therapeutic use
D010634:Phenobarbital