Fifty-eight preterm neonates evaluated by real-time sonographic scanning of the head were prospectively studied. They were divided into three groups: 13 with peri-intraven-tricular hemorrhage (PIVH) alone, 19 with subsequent ventricular dilatation and 26 control infants without ultrasound evidence of PIVH. At 12 months of age detailed neurological follow-up assessment was carried out. Five (8.6%) patients had major handicaps, 34 minor neurological abnormalities. The severity of the PIVH correlated with the neurologic outcome (p < 0.02). The incidence of major handicaps was significantly greater in the group with ventricular dilatation (p < 0.03). Among the infants with PIVH, major handicaps were only present if associated with grade III and IV. Severe posthemorrhagic ventricular dilatation increased the risk for major handicaps. Adverse neurological sequelae at follow-up appeared to be attributable to the extent of PIVH and aggravated by severe ventricular enlargement.

This study concerns the prognostic value of total cord-blood CK-BB activity measured with a new method in preterm infants at risk of PIVH. Twenty-six patients with gestational age less than 36 weeks were studied. The presence of PIVH was proved by either ultrasound scans or autopsy. Total CK-BB values in cord-blood of infants who developed PIVH were significantly higher than those of patients without cerebral bleeding (P less than 0.001).

Peri-intraventricular hemorrhage (PIVH) is an important complication of the brain in immature newborn infants. In a real-time ultrasound study with frequent scanning of 78 preterm infants (50 with birth-weight less than 1,500 g and 28 weighing more than 1,500 g), we examined the influence of sex on the occurrence of PIVH. A significant difference between sexes was only found in the group with birth-weight below 1,500 g. PIVH occurred in 72% of male infants and in 28% of females (p < 0.001). This effect is probably due to a difference in the timing of cerebral vascular maturation in males leading to a difference in the risk of developing PIVH between the sexes before 34 weeks of gestation.

Twins have higher rates of perinatal mortality, prematurity and its complications, low birth weight, intrauterine growth retardation, congenital anomalies and long-term developmental morbidity. In 31 twin pairs we evaluated the incidence and severity of peri-intraventricular hemorrhage (PIVH) and post-hemorrhagic ventricular dilatation. On ultrasonography minor PIVH (grades I and II) was observed in 26% of A twins and 25% of B twins (p < 0.5). Major PIVH (grades III and IV) was less common, occurring in 3% of A twins and 6% of B twins (p < 0.5). Ventriculomegaly, mostly regressive was equally distributed between the two groups of babies. From these results it can be concluded that with efficient antenatal care and skilful perinatal management of twin pregnancy, the incidence of major perinatal neurological complications such as PIVH and ventriculomegaly are not higher in the second-born twin.

Ventricular dilatation after periventricular/intraventricular hemorrhage (PIVH) is a more common complication than was assumed before the advent of ultrasound. In this prospective study based on 264 ultrasonic head scans, the true incidence of ventriculomegaly was investigated in two groups of preterm infants with PIVH. The major incidence of PIVH in babies with less than 34 weeks of gestation (p less than 0.05) was confirmed. Statistical analysis of the follow-up examinations showed that the degree of ventriculomegaly correlated well with the extent of the cerebral-intraventricular hemorrhage (X2 test, p less than 0.002).