Study on feasible prophylactic proposal for the periventricular-intraventricular hemorrhage in preterm infants / 中华围产医学杂志

ABSTRACT

Objective To study the feasible prophylactic proposal for the periventricular-intraventricular hemorrhage(PIVH)in preterm infants with the aim to reduce the mortality and improve the prognosis.Methods From January 2004 to June 2005,pregnant women at high risk for preterm delivery and with gestational age of less than 35 weeks and their infants were enrolled and divided into five groups randomly.Pregnant women received antenatal intramuscular or intravenously injection of vitamin K_1 10 mg per day for 2 to 7 days were Group A.Group B received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 1 day.Group C received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 2 days.Group D received dexamethasone 10 mg per day for 1 or 2 days and vitamin K_1 10 mg per day for 2 to 7 days.Infants in the phenobarbital group received intravenous injection of phenobarbital within 3 hours after birth for 3 to 5 days.Infants in the control group received neither phenobarbital after birth nor dexamethasone or vitamin K_1 injection antenatally.Results PIVH was diagnosed in 17 of 40(42.5%)in Group A,34 of 63(54.0%)in Group B,36 of 70(51.4%)in Group C,14 of 44(31.8%)in Group D,they all higher than control group(?2=15.10,P=0.004).More infants in the control group had severe PIVH(Grade Ⅲ and Ⅳ)than other groups(?2=9.527,P=0.049).The incidence of PIVH and severe PIVH in Group B and Group C were no significant difference.Furthermore,the incidence of PIVH was no difference in phenobarbital group(60.0%)and control group(65.2%)(?2=0.361,P=0.548).But the incidence of severe PIVH in phenobarbital group(5.0%)was less than control group(18.4%)(?2=4.04,P=0.044).Conclusions The combined antenatal administration of dexamethasone and vitamin K_1 can reduce the incidence of PIVH in preterm infants.Postnatal administration of phenobarbital can not decrease the incidence of PIVH,but decrease the frequency of severe PIVH.