Neurodevelopmental outcome of term infants with intraventricular hemorrhage

Intraventricular hemorrhage and its sequelae have been reported infrequently in term infants. We investigated the outcome of intraventricular hemorrhage in 15 term infants born between 1982 and 1988. One infant (7%) died. Complications of pregnancy were identified in seven mothers (47%). Age at diagnosis ranged from in utero to 28 days. Clinical presentation included feeding intolerance, fever, jaundice, irritability, and seizures. Severity of hemorrhage was of prognostic value. Of the four children with grade 4 hemorrhage, one died and the three survivors were severely handicapped. Overall, nine (64%) of 14 survivors had no or mild handicap. Perinatal alloimmune thrombocytopenia emerged as the single most important cause of severe hemorrhage and poor outcome. Identification and treatment of these infants must begin in utero if we are to prevent intraventricular hemorrhage and its complications in this group of patients.