Screening head ultrasound to detect intraventricular hemorrhage in premature infants.
OBJECTIVE
The objective of this case-control study was to develop a screening protocol using head ultrasound (HUS) to detect high-grade intraventricular hemorrhage (IVH) in very-low-birthweight infants with greater specificity than current practice, while maintaining a high degree of sensitivity.


METHODS
All infants </= 32 weeks or </= 1500 g admitted to the neonatal intensive care unit between January 1, 1991 and December 31, 1992 were studied. The 1991 cohort was analyzed to identify the factors most sensitive and specific for predicting the occurrence of a high-grade (III or IV) IVH.


RESULTS
Eighty-five percent of infants born at 28-32 weeks gestation screened by 2 weeks of age for IVH had normal HUS scans. The factors most predictive of a high-grade IVH were gestational age < 28 weeks, forceps delivery, or any of the following in the first 2 weeks of life: seizures, head circumference increasing by more than 1 cm per week, base deficit >/= 10, or cardiopulmonary resuscitation in the neonatal intensive care unit.


CONCLUSIONS
Infants born at 28-32 weeks with a high-grade IVH can be identified with a high degree of sensitivity using refined screening criteria, eliminating 50 % of the HUS scans currently obtained for IVH screening.
Chess
P R
PR
Department of Pediatrics, University of Rochester, Strong Memorial Hospital, Rochester, NY 14642, USA.
Chess
M A
MA
Manuli
M A
MA
Guillet
R
R
D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D015997:Neonatal Screening; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography