Pneumothorax in Preterm Neonates and Its Association with Intraventricular Hemorrhage

Abstract

Background: Haemorrhage into the periventricular subependymal germinal matrix with subsequent extension into the ventricles (intraventricular haemorrhage) is one of the major complications in premature infants which continues to pose challenges in neonatal intensive care units worldwide. The aim of this work was to test the hypothesis that a pneumothorax increases the risk of intraventricular hemorrhage in premature neonates. Methods: This prospective study was carried out upon 40 premature neonates with pneumothorax. Patients were divided into two equal groups: group1: preterm neonates between 28-32 weeks gestation with pneumothorax and group2: preterm neonates between 32-36 weeks gestation with pneumothorax. All patients were subjected to laboratory investigations [complete blood count, C- reactive protein, arterial blood gases], head ultrasonography and plain x-ray. Results: Birth weight, GA and MABP were significantly lower in the intraventricular haemorrhage group compared to normal group. There was statistically significant difference in mortality between both studied groups. RD was significantly higher in the intraventricular haemorrhage group compared to normal group. Conclusions: Pneumothorax in preterm neonates was associated with increase occurrence and severity of Intraventricular Haemorrhage.  Our study shows that pneumothorax can induce IVH in neonates with gestational age less than 32 weeks and birth weight less than 1000 g. These severe degrees of intraventricular haemorrhage have been associated with early mortality.