Periventricular Hemorrhage-Intraventricular Hemorrhage

Periventricular-intraventricular hemorrhage (PIVH) is a disease process that affects the premature newborn infant. Hemorrhage occurs when vessels of the germinal matrix in the periventricular area rupture, which can then extend into the ventricles as intraventricular hemorrhage (IVH). In severe cases, bleeding will occupy a significant portion of the ventricle and extend into the intraparenchymal area. Infants most at risk are those born before 33 weeks of gestational age, as after this time, the germinal matrix involutes.The second most frequent cause of death in preterm infants is PIVH and is one of the leading causes of cerebral damage in low birth-weight preterm newborns. Hyaline membrane disease is the most frequent cause of death in preterm infants.In 1978 Papile et al. developed a classification for PIVH based on the head computed tomographic scan. This classification was later adapted in 1984 for ultrasound as the equipment is portable and can be frequently repeated. The degree of hemorrhage is graded I through IV: Grade I – Germinal matrix alone Grade II – IVH without ventricular dilatation Grade III - IVH with ventricular dilatation Grade IV – IVH with intraparenchymal hemorrhage