TY - JOUR
T1 - Intraventricular hemorrhage in preterm infants and coagulation - Ambivalent perspectives?
AU - Kuperman, Amir A.
AU - Brenner, Benjamin
AU - Kenet, Gili
PY - 2013/1
Y1 - 2013/1
N2 - Intraventricular hemorrhage (IVH) is a major complication of preterm birth, and large hemorrhages may yield significant future disability. During the last few decades, the survival of preterm infants has increased dramatically. Nevertheless, morbidity is still a major problem especially for very young and extremely low birth weight infants. As both, mortality and incidence of morbidities known to influence outcome, show a weekly decline with increasing gestational age, prematurity and low birth weight have been identified as major risk factors for IVH occurrence. This stems probably from the increased vulnerability of the premature germinal matrix as well as the physiologically impaired hemostasis, demonstrated in neonates. The hypothesis that a severe coagulation deficiency in the premature newborn could be a major contributing factor for IVH has been suggested, and small open label interventional studies targeting the premature coagulation system have been conducted with ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII and prothrombin complex concentrate. Nevertheless, potential venous origin of hemorrhages, which may be related to thrombophilic risk factors, has also been discussed. The following manuscript will focus upon IVH pathogenesis and address potential therapies.
AB - Intraventricular hemorrhage (IVH) is a major complication of preterm birth, and large hemorrhages may yield significant future disability. During the last few decades, the survival of preterm infants has increased dramatically. Nevertheless, morbidity is still a major problem especially for very young and extremely low birth weight infants. As both, mortality and incidence of morbidities known to influence outcome, show a weekly decline with increasing gestational age, prematurity and low birth weight have been identified as major risk factors for IVH occurrence. This stems probably from the increased vulnerability of the premature germinal matrix as well as the physiologically impaired hemostasis, demonstrated in neonates. The hypothesis that a severe coagulation deficiency in the premature newborn could be a major contributing factor for IVH has been suggested, and small open label interventional studies targeting the premature coagulation system have been conducted with ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII and prothrombin complex concentrate. Nevertheless, potential venous origin of hemorrhages, which may be related to thrombophilic risk factors, has also been discussed. The following manuscript will focus upon IVH pathogenesis and address potential therapies.
KW - Intraventricular hemorrhage
KW - Prematurity
KW - Recombinant factor VIIa
KW - Thrombin
KW - Vitamin K
UR - http://www.scopus.com/inward/record.url?scp=84875154016&partnerID=8YFLogxK
U2 - 10.1016/s0049-3848(13)70018-5
DO - 10.1016/s0049-3848(13)70018-5
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C2 - 23452738
AN - SCOPUS:84875154016
SN - 0049-3848
VL - 131
SP - S35-S38
JO - Thrombosis Research
JF - Thrombosis Research
IS - SUPPL.1
ER -