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Cosmina Cristea

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

HEMORAGIA PERI-INTRAVENTRICULARA LA PREMATURI: IMPORTANTA SCREENINGULUI PRIN ECOGRAFIE TRANSFONTANELARA

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 4, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HEMORAGIA PERI-INTRAVENTRICULARA LA PREMATURI: IMPORTANTA SCREENINGULUI PRIN ECOGRAFIE TRANSFONTANELARA

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ABSTRACT

Obiective. Hemoragiile peri-intraventriculare (HPIV) pot determina la sugarii născuţi prematur diferite grade de re tard neuropsihomotor. Un studiu prospectiv efectuat în IOMC pe o perioadă de 4 ani (2009-2012), pe un lot de 160 prematuri, a urmărit prevalenţa gradelor de HPIV diagnosticate prin ecografie transfontanelară (ETF), identificarea factorilor de risc asociaţi şi a severităţii afectării neurologice la aceşti pacienţi prin urmărirea lor pe o perioadă de 12 luni.

Material şi metodă. Pe perioada studiului, prematurii internaţi în IOMC au fost examinaţi sistematic prin ETF, printr-un protocol standardizat; aprecierea gradelor HPIV s-a efectuat conform clasificării Papile. Evaluarea neurologică a fost efectuată sistematic până la vârsta de 1 an.

Rezultate. Cel mai frecvent înregistrate au fost HPIV I şi II – 45%, respectiv 37,5% din numărul total de pacienţi. HPIV gradul IV au reprezentat 4,4%. În HPIV grad I şi II afectarea neurologică a fost uşoară, această corelaţie având semnificaţie statistică (p < 0,01) pentru ambele forme. Hemoragiile gradul III şi IV au fost asociate cu o evoluţie neurologică nefavorabilă, corelaţia între HPIV grad IV şi sechelele neurologice majore având semnificaţie statistică (p < 0,01).

Concluzii. ETF efectuată de rutină tuturor prematurilor permite diagnosticul precoce şi stadializarea HPIV, aprecierea evoluţiei neurologice cu instituirea precoce a tratamentului şi asigurarea consilierii adecvate.

Cuvinte cheie: prematur, ecografie transfontanelară, hemoragie peri-intraventriculară, prognostic neurologic

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PERI-INTRAVENTRICULAR HEMORRHAGE IN PRETERM INFANTS: THE IMPORTANCE OF SCREENING BY TRANSFONTANELLAR ULTRASOUND

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 4, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

PERI-INTRAVENTRICULAR HEMORRHAGE IN PRETERM INFANTS: THE IMPORTANCE OF SCREENING BY TRANSFONTANELLAR ULTRASOUND

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ABSTRACT

Objectives. In preterm babies, peri-intraventricular hemorrahges (PIVH) might cause various degrees of neuropsycho-motor impairment. A 4-year prospective study (2009-2012) performed in the IOMC, was aimed to determine the prevalence of different degrees of PIVH diagnosed by head ultrasound (HUS) among 160 admitted preterm babies, the associated risk factors, along with the neuro-developmental effects on a 12-month follow-up period.

Material and methods. In the above-mentioned period all admitted preterms were examined by transfontanelar ultrasound according to a standardized protocol based on Papile’s PIVH classification. For those preterms included in the study a 12-month systematic neurologic follow-up was performed. Results. PIVH grade I (45%) and II (37,5%) were the most prevalent types. Grade IV PIVH represented 4,4% from all PIVH cases. The good neurological outcome of grade I and II PIVH, was found to be statistically significant (p < 0.01) for both types. Severe neurological sequelae were associated with grade III and IV and a statistically significant correlation (p<0.01) was found only for grade IV hemorrhages.

Conclusion. Systematic HUS screenings for all preterm babies is useful for early diagnosis and PIVH staging, for neurologic outcome prediction, providing the appropriate management strategy and a well-suited parental counseling.

Key words: preterm, transfontanelar ultrasound, peri-intraventricular hemorrhage, neurological outcome

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