title: Intraventricular haemorrhage in preterm infants--can we improve outcome by addressing coagulation?
abstract: During the last few decades, the survival of preterm infants has increased dramatically. Nevertheless, with the increasing number of very young and extremely low birth weight infants, morbidity is still a major problem. Intraventricular Haemorrhage (IVH) is a major complication of preterm birth, and large haemorrhages or haemorrhages associated with parenchymal brain lesions may yield a high rate of future disability. IVH is a complex, multi-factorial disorder. Prematurity and low birth weight remain as its most important risk factors, affecting vulnerability of the germinal matrix as well as the coagulation system. Approximately 80% of IVHs occur by 72 h after birth, but a considerable proportion of IVH is already visible on the first cranial ultrasound scan within a few hours of birth. The hypothesis that a severe coagulation deficiency in the premature newborn could be a major contributing factor to IVH has been suggested, and small open label interventional studies targeting the premature coagulation system have been conducted with ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII and prothrombin complex concentrate. The outcome of these studies will be reviewed.
authors: a Pediatric Hematology Clinic, Thrombosis and Hemostasis Service, Institute of Hematology, Western Galilee Hospital , Naharriya , Israel .|b Faculty of Medicine in the Galilee , Bar-Ilan University , Safed , Israel .
authors: Amir A
authors: AA
authors: Kuperman
authors: c Thrombosis and Hemostasis Unit , Institute of Hematology , Rambam Medical Center , Israel .|d The Bruce Rappaport Faculty of Medicine , The Technion , Haifa , Israel .
authors: Benjamin
authors: B
authors: Brenner
authors: e Thrombosis Unit , National Hemophilia Center, Sheba Medical Center , Tel Hashomer , Israel , and.|f Sackler Faculty of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
authors: Gili
authors: G
authors: Kenet
mesh_terms: D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001921:Brain / Q000196:embryology / Q000254:growth & development; D002552:Cerebral Ventricles / Q000098:blood supply; D004979:Ethamsylate / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use; D005865:Gestational Age; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D010949:Plasma; D011994:Recombinant Proteins / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome; D014812:Vitamin K / Q000627:therapeutic use
chemical_list: D001779:Blood Coagulation Factors; D006490:Hemostatics; D011994:Recombinant Proteins; D014812:Vitamin K; D004979:Ethamsylate; C025667:prothrombin complex concentrates; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: Intraventricular haemorrhage; prematurity; recombinant factor VIIa; thrombin; vitamin K