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Management and complications of intraventricular hemorrhage in the newborn

Lisa M Adcock, MD
Section Editors
Douglas R Nordli, Jr, MD
Joseph A Garcia-Prats, MD
Deputy Editor
Melanie S Kim, MD


Intraventricular hemorrhage (IVH) (also known as subependymal/intraventricular hemorrhage) is an important cause of brain injury in premature infants. The negative impact of IVH on neurodevelopmental outcome is due not only to the direct consequences of IVH, but also to associated lesions, such as posthemorrhagic hydrocephalus (PHH) and periventricular leukomalacia (PVL).

Although the incidence of IVH in very low birth weight (VLBW) infants (birth weight [BW] <1500 g) has declined from rates as high as 40 to 50 percent in the late 1970s to 20 to 25 percent in 2010, the absolute numbers of infants with IVH remain significant. This is due to the increased survival rate of premature infants, especially in the extremely low birth weight (ELBW) category (BW below 1000 g) who continue to be at risk for IVH [1,2]. (See "Clinical manifestations and diagnosis of intraventricular hemorrhage in the newborn", section on 'Epidemiology'.)

The prevention, management, complications, and outcome of IVH in the premature newborn are discussed in this topic review. The epidemiology, pathogenesis, clinical manifestations, and diagnosis of IVH are discussed separately. (See "Clinical manifestations and diagnosis of intraventricular hemorrhage in the newborn".)


The severity of IVH is based on the presence and amount of blood in the germinal matrix and lateral ventricles as demonstrated by cranial ultrasound (table 1):

Grade I: Only germinal matrix hemorrhage.

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Literature review current through: Nov 2017. | This topic last updated: May 10, 2017.
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