Incidência de hemorragia peri-intraventricular em recém-nascidos pré-termo e a relação com o peso ao nascer
DOI:
https://doi.org/10.7322/jhgd.19829Palavras-chave:
Ultra-som transfontanelar, Hemorragia periventricular-intraventricular, Recém-nascido pré-termoResumo
A caracterização das hemorragias periventriculares-intraventriculares (HPIV) no período neonatal em recém-nascidos pré-termo constitui um evento importante para a prevenção de seqüelas em curto e longo prazo. Foi objetivo deste estudo avaliar a freqüência da hemorragia peri-intraventricular (HPIV) em recém-nascidos pré-termo e correlacioná-la com o peso ao nascer, num estudo observacional e transversal realizado em uma unidade de terapia intensiva neonatal, do Hospital do Servidor Público Estadual (HSPE), na cidade de São Paulo no período de janeiro de 1996 a dezembro de 1997. Foram incluídos no estudo 70 de 102 recém-nascidos com peso menor de 2000g, sendo utilizada a classificação de Papille, que classifica HPIV em quatro graus, conforme a extensão da mesma. As ecografias foram realizadas nos 4º, 8º, 15º e 28º dias de vida, desde que os recém-nascidos permanecessem internados na unidade de cuidados intensivos do HSPE. Foram diagnosticados 32 casos de HPIV. Houve correlação estatisticamente significante (pd"0,001) do peso com a ocorrência da HPIV, sendo que o grupo acometido foi o que apresentou menor média de peso. Assim, a HPIV é um evento freqüente em recém-nascidos pré-termo e está relacionada com peso ao nascer inferior a 1500g. O exame ultra-sonográfico mostrou-se eficaz no diagnóstico, devendo a partir do diagnóstico da HPIV, haver o encaminhamento do recém-nascido para ao acompanhamento ambulatorial com equipe multidisciplinar.Downloads
Referências
Abreu LC. A hemorragia peri-intraventriculardo recém-nascido pré-termo, Fisio Brasil,2004: 65(1):38-42.
Abreu LC. Efeitos terapêuticos da fisioterapia pulmonar e motora em recém-nascidos pré-termo com hemorragia periventricular-intraventricular, Tese (Mestrado em Reabilitação) UNIFESP/EPM, São Paulo, 1998.
Abreu LC, Angheben JMM, Braz PF, Oliveira AG, Falcão MC, Saldiva PHN. Effect of the neonatal physiotherapy in the heart rate in preterm infant with respiratory distress syndrome after replacement of exogenous surfactant. Arq Med ABC.2006;31(1):5-11.
Jorch G, Jorch N. Failure of auto regulation of cerebral blood flow in neonates studies by pulsed Doppler ultrasound of internal carotidartery. Eur J Pediatr. 1987;146:468-72.
Miall-Allen VM, De Vries LS, Whitelaw AG. Mean arterial blood pressure and neonatal cerebral lesions. Arch Dis Child.1987;62:1068-9.
Volpe JJ. Neurology of new born. 3rd ed.Philadelphia: WB Saunders; 1995.
Assis MC, Machado HR. Ecografia transfontanelar com fluxo a cores em recém-nascidos prematuros. Arq Neuropsiquiatr. 2004;62:68-74.
Ferreiro DM Neonatal brain injury. N Engl J Med. 2004;1985-1995.
Gross SI, Mettelman BB, Dye TD, Slagle TA. Impact of family structure and stability on academic outcome in preterm children at 10years of age. J Pediatr. 2001;138(2):169-75.
Victora CG, Barros FC, Kirkwood BR, Vaughan JP. Pneumonia, diarrhea, and growth in the first 4 years of life: a longitudinal study of 5914 urban Brazilian children. Am J Clin Nutr. 1990;52(2):391-6.
Leal MC, Gama SGN, Cunha CB. Desigualdades sócio-demográficas e suas conseqüências sobre o peso do recém-nascido. Rev. Saúde Pública. 2006;40(3):466-473.
Stathis SL, O. Callaghan M, Harvey J, Rogers Y. Head circumference in ELBW babies is associated with learning difficulties and cognition but not ADHD in the school-aged child. Dev Med Child Neurol. 1999;41:375-80.
Hack M, Taylor HG. Perinatal brain injury in preterm infants and later neurobehavior function. JAMA. 2000;284:1973-4.
Saigal S, Hoult LA, Streiner DL, Stoskopf BL, Rosenbaum PL. School difficulties at adolescence in a regional cohort of children who were extremely low birth weight. Pediatrics. 2000;105:325-31.
Schendel DE, Stockbauer JW, Hoffman HI, Herman AA, Berg CJ, Schramm WF. Relation between very low birth weight and developmental delay among preschool children disabilities. Am J Epidemiol.1997;146(9):740-9.
Leonard CH, Piecuch RE. School age outcome in low birth weight preterm infants. Semin Perinatol. 1997;21:240-53.
Botting N, Powls A, Cooke RW, Marlow N. Cognitive and educational outcome of very-low-birth weight children in early adolescence. Dev Med Child Neurol. 1998;40:652-60.
Grunau RE, Whitfield MD, Davis C. Pattern of learning disabilities in children with extremely low birth weight and broadly average intelligence. Arch Pediatr Adolesc Med. 2002;156:615-20.
Ohlweiler L, Silva AR, Barros SV, Riesgo R, Rotta NT. Influence of intracranial hemorrhage and neonatal seizures on the neurological and psychomotor development of premature infants at Hospital de Clinicas de Porto Alegre, Brazil. Arq Neuropsiquiatr.2003: 61:902-905.
Stopiglia MS, Ribeiro MM, Valeriana L, Marba S. Neurological evaluation of neonates with intraventricular and periventricular hemorrhage. Arq. Neuro-Psiquiatr. 1999;57(2B):366-370.
Capurro H, Konichezky S, Fonseca D, Caldeyro-Barcia R. A simplified method for diagnostic of gestacional age in the new born infant. J. Pediatr. 1978; 93: 102-12.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of sub ependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978, 92:529-534.
Bussat WO e Morettin PA. Estatística Básica.3.ed. São Paulo: Atual. 321p. (Coleção Métodos Quantitativos), 1987.
Campos H. Estatística Experimental Não Paramétrica. Piracicaba: ESALQ. 343p. 1979.
Volpe JJ. Intraventricular hemorrhage in premature infant: morfhologic characteristics. In: Pollin RA, Fox WW. Fetal and neonatal physiology. Philandelphia, W.B. Sauders Company, EUA. 1992: p. 1598-1608.
McMenamin JB, Shackerlford GD, Volpe JJ. Outcome of neonatal intraventricular hemorrhage with periventricular echolenselesions. Ann. Neurol. 1984;15: 285-90.
Farage L e Assis MC. Ultrasonic findings of intracranial hemorrhage in preterm neonates. Arq. Neuro-Psiquiatr. 2005; 63(3b): 814-816.
Downloads
Publicado
Edição
Seção
Licença
CODE OF CONDUCT FOR JOURNAL PUBLISHERS
Publishers who are Committee on Publication Ethics members and who support COPE membership for journal editors should:
- Follow this code, and encourage the editors they work with to follow the COPE Code of Conduct for Journal Edi- tors (http://publicationethics.org/files/u2/New_Code.pdf)
- Ensure the editors and journals they work with are aware of what their membership of COPE provides and en- tails
- Provide reasonable practical support to editors so that they can follow the COPE Code of Conduct for Journal Editors (http://publicationethics.org/files/u2/New_Code.pdf_)
Publishers should:
- Define the relationship between publisher, editor and other parties in a contract
- Respect privacy (for example, for research participants, for authors, for peer reviewers)
- Protect intellectual property and copyright
- Foster editorial independence
Publishers should work with journal editors to:
- Set journal policies appropriately and aim to meet those policies, particularly with respect to:
– Editorial independence
– Research ethics, including confidentiality, consent, and the special requirements for human and animal research
– Authorship
– Transparency and integrity (for example, conflicts of interest, research funding, reporting standards
– Peer review and the role of the editorial team beyond that of the journal editor
– Appeals and complaints
- Communicate journal policies (for example, to authors, readers, peer reviewers)
- Review journal policies periodically, particularly with respect to new recommendations from the COPE
- Code of Conduct for Editors and the COPE Best Practice Guidelines
- Maintain the integrity of the academic record
- Assist the parties (for example, institutions, grant funders, governing bodies) responsible for the investigation of suspected research and publication misconduct and, where possible, facilitate in the resolution of these cases
- Publish corrections, clarifications, and retractions
- Publish content on a timely basis