Hemorragia intraventricular asociada a asfixia perinatal en recién nacidos prematuros de 27 a 36 semanas de gestación en el área de UCIN del Hospital General Guasmo Sur, periodo 2018-2022.

Abstract

Introduction: Intraventricular hemorrhage (IVH) or hemorrhage of the germinal matrix tissue (HMG), is the most common hemorrhage in premature newborns, during the first hours or days, it can cause a rupture in the ventricular system in addition to the brain parenchyma. It is an important problem in premature babies and it can be caused by an alteration of cerebral blood flow or a lesion of the capillary bed at the level of the germinal matrix (1). This condition mainly affects premature newborns due to their immaturity and organic fragility. Several studies have associated this condition with the appearance of various complications, among which are the presence of seizures and hydrocephalus, whose rates and mortality were significantly higher (1). Objective: The main objective of this study is to determine the clinical and epidemiological characteristics of intraventricular hemorrhage associated to perinatal asphyxia in the NICU area at the Guasmo Sur General Hospital during the period 2018-2022. Methodology: It is an observational, retrospective and cross-sectional study, the study population consists of premature newborn patients in the NICU area of the HGGS in the city of Guayaquil, it will be carried out through the systematic review of clinical records at the hospital database. Among the inclusion criteria are those premature newborn patients with a gestational age of 27 to36 weeks who present an ultrasound diagnosis of intraventricular hemorrhage and who have theircomplete medical records, in the same way, all patients who have the following criteria will be excluded: full-term newborn patients, patients with incomplete clinical histo ries and those who do not present the study pathology. Results: Of the 74 patients analyzed, 35 (46%) are female and 40 (53%) are male; Regarding gestational age, the highest frequency was found in the range of 30 to 34 SG with a total of 36 (48.65%) followed by those patients under 30 SG with 20 (27.03%) and those between 34 and 36 SG with 18 (24.32%), the way of delivery most involved was cesarean section, covering 60 (81.1%) cases, while vaginal delivery represented only 14 (18.9%) of the total number of patients,Another important factor was the Apgar value at 5 minutes, evidencing that of the 74 neonates with intraventricular hemorrhage and perinatal asphyxia, 72 (97.3%) had an Apgar score less than7, while only 2 (2.7%) had an Apgar more than 7, the most frequent grades of HIV were grade II which had the most common presentation (64%), followed by grade I (24.3%). Conclusion: Male sex was more frequent, the most frequent gestational age was between 30 and 34 weeks, prematurity, low birth weight and cesarean delivery were risk characteristics in this population, grade I and II intraventricular hemorrhage were the most frequent presentations, while severe grades such as III and IV had a low incidence, however, these were more evident in those neonates under 30 SG.