Intraventricular Hemorrhage (IVH) of the Newborn

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KEY POINTS

• Intraventricular hemorrhage (IVH) is bleeding into the spaces in the brain (ventricles) that contain cerebrospinal fluid (CSF).
• Your child may need surgery to put in a tube to drain the extra fluid from the brain. Your child may receive medicines to prevent or treat seizures also.
• Follow the full course of treatment prescribed by your healthcare provider. Ask your provider how to take care of your child at home.

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What is an intraventricular hemorrhage (IVH)?

Intraventricular hemorrhage (IVH) is bleeding into the spaces in the brain that contain cerebrospinal fluid (CSF). These spaces are called ventricles.

Blood vessels in the brains of premature infants are fragile. Babies who are born more than 10 weeks early (before 30 weeks of pregnancy) are most at risk to have this bleeding within the first 5 days of life. It’s most common in babies born early who also have:

• Trouble breathing
• Trouble with their blood pressure
• Other medical problems

This problem can also happen in healthy babies.

Small amounts of bleeding do not usually cause any long-term damage. Severe bleeding can cause a buildup of fluid in the brain. The buildup of fluid can damage the brain, causing problems with learning, growth, and behavior.

What is the cause?

Blood vessels grow stronger in the last 10 weeks of the pregnancy. If a baby is born early, the vessels are more fragile. Changes in blood pressure through the fragile blood vessels can cause them to break and start bleeding. Babies with lung problems who need a machine to help them breathe are more likely to have IVH. The cause is not always known.

What are the symptoms?

A baby with IVH may not have any symptoms, or symptoms may include:

• Trouble breathing
• Changes in heart rate and blood pressure
• Less muscle tone
• Weak suck when feeding
• A high pitched cry
• Seizures

How is it diagnosed?

Every baby born more than 10 weeks early (before 30 weeks of pregnancy) is checked for IVH. Your baby may have an ultrasound scan, which uses sound waves to show pictures of the brain.

How is it treated?

In most cases, your baby’s body will get rid of small amounts of blood and fluid over several weeks. If your baby has a buildup of fluid, it can damage the brain. The most common treatment is surgery to put a tube inside your baby’s body to drain the extra fluid from the brain. The tube, called a shunt, drains the fluid into the belly or chest. Your child may need several surgeries throughout life as your child grows, or if the shunt gets blocked or infected.

Your healthcare provider will treat any lung problems and infections and, if needed, help your baby breathe. Your baby may be given a blood transfusion. Your baby will be treated with medicines if needed for seizures.

How can I take care of my child?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will get your child’s test results
• How long it will take for your child to recover
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.