Antenatal phenobarbital to prevent or minimize intraventricular hemorrhage in the low-birthweight neonate
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1College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City.
Objective:
To review the evidence that antenatal phenobarbital can reduce the incidence or severity of periventricular-intraventricular hemorrhage (PIVH) in low-birthweight neonates.
Data Sources:
MEDLINE searches were conducted with fan searches of all papers.
Study Selection:
Emphasis was placed on human data supplemented by relevant animal data.
Data Synthesis:
The barbiturates have been used to reduce hypoxic-ischemic cerebral events. Giving phenobarbital to high-risk pregnant women allows the drug to be in therapeutic concentrations during the critical period when PIVH occurs in low-birthweight infants. Current data suggest that antenatal phenobarbital can decrease the severity of PIVH; fewer data are available stating that it can decrease the incidence of PIVH.
Conclusions:
Evidence supports the hypothesis that antenatal phenobarbital is effective in decreasing the severity of PIVH in low-birthweight neonates. Further data are necessary regarding the incidence of low Apgar scores and respiratory depression in neonates given antenatal phenobarbital.