[Incidence, evolution and prognosis of posthemorrhagic ventriculomegaly in a population of newborns of less than 33 weeks gestational age].
BACKGROUND
Posthemorrhagic ventriculomegaly is one of the most important neurological problems encountered in the premature new-born. The aim of this study was to evaluate its incidence in a tertiary neonatal unit at Lille, France, to study its evolution, the risk of ventriculoperitoneal shunt and the neurodevelopmental outcome.


METHODS
Ninety-one neonates with posthemorrhagic ventriculomegaly, born before 33 weeks of gestational age (GA) and admitted in this unit between January 1989 and December 1995 were retrospectively studied. Clinical data, evolution of ventriculomegaly and outcome at 2 years were extracted from the files.


RESULTS
Incidence of ventriculomegaly was stable along the study period, around 6.1% of the admissions of neonates with the same GA; 44 had moderate ventriculomegaly and 47 severe. The mean GA was 28.7 +/- 1.9 weeks. Fifteen percent of the newborns had received corticosteroids before delivery. Spontaneous delivery (P = 0.04) and infection (P = 0.002) were more frequent in case of severe ventriculomegaly. Ventriculoperitoneal shunt was inserted in 19.1% (9/47) of infants with severe ventriculomegaly. Outcome in this population was poor. Forty-nine (54%) died before the end of the first year of life. Thirteen (30.9%) of the survivors developed cerebral palsy. In 12 out of these 13 cases, cerebral palsy was associated with parenchymal involvement in the neonatal period.


CONCLUSIONS
Long-term prognosis of ventriculomegaly is poor. In front of new therapeutic approach, an active policy towards prevention with large use of antenatal corticosteroids would allow to reduce incidence, mortality and morbidity in the neonatal period.
Pierrat
V
V
Service de médecine néonatale, hôpital Jeanne-de-Flandre, Lille, France.
Bevenot
S
S
Truffert
P
P
Duquennoy
C
C
Lequien
P
P
D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D002552:Cerebral Ventricles / Q000002:abnormalities*; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D004452:Echocardiography; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D011379:Prognosis; D012307:Risk Factors; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects