Periventricular leucomalacia in premature infants in neonatal ward, Cipto Mangunkusumo Hospital: A preliminary study
Keywords:
premature infant, periventricular leucomalacia, prevalence, cranial ultrasound scan
Abstract
Introduction Periventricular leucomalacia (PVL) is a major causeof neurodevelopment delay in premature infants, so early detec-
tion of the preterm infant at high risk for the subsequent develop-
ment of this lesion is critical.
Objectives To determine the prevalence of PVL in premature in-
fants hospitalized in neonatal ward, Cipto Mangunkusumo Hospi-
tal using cranial ultrasound scans and define its characteristics
Methods Premature infants hospitalized in the neonatal ward from
January to July 2003 were included in this study. Clinical features
were retrieved from medical charts. Ultrasound scan was performed
once, after the age of 7 days and interpretations were read sepa-
rately by two consultants of the radiology division.
Results Fifty-one infants were included, 21 with <32-week gesta-
tion, 30 with >32-week gestation; birth weight range were 1000 to
2600 gram. Nineteen infants had cystic lesion and/or dilatation of
the ventricle from the cranial ultrasound scan. The prevalence of
PVL in gestational age (GA) of <32 weeks was 6/21 and that in GA
of >32 weeks was 13/30. Risk factors found in infants with PVL
were maternal infection, respiratory distress, sepsis and circula-
tory failure.
Conclusion The prevalence of PVL in preterm infants in Cipto
Mangunkusumo neonatal ward was higher than that was reported
in developed countries. Maternal infection, respiratory distress,
sepsis, and circulatory failure which were commonly found in these
infants were factors to be considered as risks for PVL
References
1. Sutton PD. Births, marriage, divorces and deaths:
provisional data for January 2003. National Vital Sta-
tistics Reports. Volume 52 no.1. Maryland: Natural
Center for Health Statistics; 2003.
2. Escobar GJ, Littenberg B, Petitti DB. Outcome among
surviving very low birth weight infants: a meta-analy-
sis. Arch Dis Child 1991;66:204-11
3. Subbagian Neonatologi Ilmu Kesehatan Anak FKUI/
RSCM. Morbiditas dan mortalitas neonatus di rumah
sakit rujukan RSCM tahun 2001. Annual report. Un-
published.
4. Bucher HU, Ochsner Y, Fauchçre JC, Swiss Neonatal Net-
work. Two years outcome of very preterm and very low
birth weight infants in Switzerland. Swiss Med Wkly
2003;133:93-9
5. Barton L, Hodgman JE, Pavlova Z. Causes of death in
the extremely low birth weight infant. Pediatrics
1999;103:406-51
6. Iriondo M, Alcover E, Lizarraga I, Campistrol J, Poo P,
Ibanez M, et al. Sequelae prediction for cranial ultra-
sound in newborns <1500 g. RELAN 1999;1:123-8
7. Banker BQ, Larroche JC. Periventricular leukomalacia
of infancy. Arch Neurol 1962;7:386-40
8. Bulas DI, Vezina GL. Preterm anoxic injury, radiologic
evaluation. Radiol Clin N Am 1999;37:1146-62
9. Volpe JJ. Neurology of the newborn. 4th ed. Philadel-
phia: WB Saunders; 2001. p. 297-394
10. Subramaniam KNS. Pathophysiology of germinal ma-
trix-related hemorrhage and ischemia. In: Grant EG,
editor. Neurosonography of the preterm neonate. New
York: Springer-Verlag; 1986. p. 25-32
11. Hill A, Volpe JJ. Hypoxic-ischemic cerebral injury in
the newborn. In: Swaiman KF, Ashwal S, editors. Pe-
diatric neurology, principles and practice. 3rd edition.
Missoury: Mosby; 1999. p. 191-204
12. Volpe JJ. Intraventricular hemorrhage and brain injury
in the premature infant neuropathology and patho-
genesis. Clin Perinatol 1989;16:361-86
13. Armstrong D, Norman MG. Periventricular
leucomalacia in neonates: complications and sequelae.
Arch Dis Child 1974;49:367-75
14. Graziani LJ, Spitzer AR, Mitchell DG, Merton DA,
Stanley C, Robinson N, et al. Mechanical ventilation
in preterm infants: neurosonographic and developmen-
tal studies. Pediatrics 1992;90:515-22
15. Fujimoto S, Togari H, Yamaguchi N, Mizotani F, Suzuki
S, Sobajima H. Hypocarbia and cystic periventricular
leukomalacia in premature infants. Arch Dis Chil
1994;71:F107-10
16. Perlman JM, Risser R, Broyles RS. Bilateral cystic
periventricular leukomalacia in the premature infant:
associated risk factors. Pediatrics 1996;97:822-7
17. Perlman JM, Rollins N. Surveillance protocol for the
detection of intracranial abnormalities in premature
neonates. Arch Pediatr Adolesc Med 2000;134:822-6
18. Wiswell TE, Graziani LJ, Kornhauser MS, Stanley C,
Merton DA, McKee L. Effects of hypocarbia on the
development of cystic periventricular leukomalacia in
premature infants treated with high-frequency jet ven-
tilation. Pediatrics 1996;98:918-24
19. De Reuck J, Chattha AS, Richardson Jr.EP. Pathogen-
esis and evolution of periventricular leukomalacia in
infancy. Arch Neurol 1972;27:229-40
20. Dammann O, Leviton A. Maternal intrauterine infec-
tion cytokines and brain damage in the preterm new-
born [review]. Pediatr Res 1997;42:1-8
21. Paneth N, Rudelli R, Monte W, Rodriguez, Pinto J,
Kairam R, et al. White mater necrosis in very low
birthweight infants: neuropathologic and
ultrasonographic findings in infants surviving six days
or longer. J Pediatr 1990;116:975-84
22. Slovis TL, Shankaran S. Ultrasound in the evaluation
of hypoxic-ischaemic injury and intracranial hemor-
rhage in neonates: the state of the art. Pediatr Radiol
1984;14:67-75
23. Murphy DJ, Squier MV, Hope PL, Sellers S, Johnson
A. Clinical association and time of onset of cerebral
white matter damage in very preterm babies. Arch Dis
Child 1996;75:F27
24. Boal DKB, Watterberg KL, Miles S, Gifford KL. Optimal
cost-effective timing of cranial ultrasound screening in
low birth-weight infants. Pediatr Radiol 1995;25:425-8
25. Ment LR, Bada HS, Barnes P, Grant PE, Hirtz D, Papile
LA, et al. Practice parameter: neuroimaging of the neo-
nate. Report of the quality standards subcommittee of
the American Academy of Neurology and the prac-
tice committee of the Child Neurology Society. Neu-
rology 2002;58:1726-38
26. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman
BL, Lipp R. New Ballard score, expanded to include ex-
tremely premature infants. J Pediatr 1991;119:417-23
provisional data for January 2003. National Vital Sta-
tistics Reports. Volume 52 no.1. Maryland: Natural
Center for Health Statistics; 2003.
2. Escobar GJ, Littenberg B, Petitti DB. Outcome among
surviving very low birth weight infants: a meta-analy-
sis. Arch Dis Child 1991;66:204-11
3. Subbagian Neonatologi Ilmu Kesehatan Anak FKUI/
RSCM. Morbiditas dan mortalitas neonatus di rumah
sakit rujukan RSCM tahun 2001. Annual report. Un-
published.
4. Bucher HU, Ochsner Y, Fauchçre JC, Swiss Neonatal Net-
work. Two years outcome of very preterm and very low
birth weight infants in Switzerland. Swiss Med Wkly
2003;133:93-9
5. Barton L, Hodgman JE, Pavlova Z. Causes of death in
the extremely low birth weight infant. Pediatrics
1999;103:406-51
6. Iriondo M, Alcover E, Lizarraga I, Campistrol J, Poo P,
Ibanez M, et al. Sequelae prediction for cranial ultra-
sound in newborns <1500 g. RELAN 1999;1:123-8
7. Banker BQ, Larroche JC. Periventricular leukomalacia
of infancy. Arch Neurol 1962;7:386-40
8. Bulas DI, Vezina GL. Preterm anoxic injury, radiologic
evaluation. Radiol Clin N Am 1999;37:1146-62
9. Volpe JJ. Neurology of the newborn. 4th ed. Philadel-
phia: WB Saunders; 2001. p. 297-394
10. Subramaniam KNS. Pathophysiology of germinal ma-
trix-related hemorrhage and ischemia. In: Grant EG,
editor. Neurosonography of the preterm neonate. New
York: Springer-Verlag; 1986. p. 25-32
11. Hill A, Volpe JJ. Hypoxic-ischemic cerebral injury in
the newborn. In: Swaiman KF, Ashwal S, editors. Pe-
diatric neurology, principles and practice. 3rd edition.
Missoury: Mosby; 1999. p. 191-204
12. Volpe JJ. Intraventricular hemorrhage and brain injury
in the premature infant neuropathology and patho-
genesis. Clin Perinatol 1989;16:361-86
13. Armstrong D, Norman MG. Periventricular
leucomalacia in neonates: complications and sequelae.
Arch Dis Child 1974;49:367-75
14. Graziani LJ, Spitzer AR, Mitchell DG, Merton DA,
Stanley C, Robinson N, et al. Mechanical ventilation
in preterm infants: neurosonographic and developmen-
tal studies. Pediatrics 1992;90:515-22
15. Fujimoto S, Togari H, Yamaguchi N, Mizotani F, Suzuki
S, Sobajima H. Hypocarbia and cystic periventricular
leukomalacia in premature infants. Arch Dis Chil
1994;71:F107-10
16. Perlman JM, Risser R, Broyles RS. Bilateral cystic
periventricular leukomalacia in the premature infant:
associated risk factors. Pediatrics 1996;97:822-7
17. Perlman JM, Rollins N. Surveillance protocol for the
detection of intracranial abnormalities in premature
neonates. Arch Pediatr Adolesc Med 2000;134:822-6
18. Wiswell TE, Graziani LJ, Kornhauser MS, Stanley C,
Merton DA, McKee L. Effects of hypocarbia on the
development of cystic periventricular leukomalacia in
premature infants treated with high-frequency jet ven-
tilation. Pediatrics 1996;98:918-24
19. De Reuck J, Chattha AS, Richardson Jr.EP. Pathogen-
esis and evolution of periventricular leukomalacia in
infancy. Arch Neurol 1972;27:229-40
20. Dammann O, Leviton A. Maternal intrauterine infec-
tion cytokines and brain damage in the preterm new-
born [review]. Pediatr Res 1997;42:1-8
21. Paneth N, Rudelli R, Monte W, Rodriguez, Pinto J,
Kairam R, et al. White mater necrosis in very low
birthweight infants: neuropathologic and
ultrasonographic findings in infants surviving six days
or longer. J Pediatr 1990;116:975-84
22. Slovis TL, Shankaran S. Ultrasound in the evaluation
of hypoxic-ischaemic injury and intracranial hemor-
rhage in neonates: the state of the art. Pediatr Radiol
1984;14:67-75
23. Murphy DJ, Squier MV, Hope PL, Sellers S, Johnson
A. Clinical association and time of onset of cerebral
white matter damage in very preterm babies. Arch Dis
Child 1996;75:F27
24. Boal DKB, Watterberg KL, Miles S, Gifford KL. Optimal
cost-effective timing of cranial ultrasound screening in
low birth-weight infants. Pediatr Radiol 1995;25:425-8
25. Ment LR, Bada HS, Barnes P, Grant PE, Hirtz D, Papile
LA, et al. Practice parameter: neuroimaging of the neo-
nate. Report of the quality standards subcommittee of
the American Academy of Neurology and the prac-
tice committee of the Child Neurology Society. Neu-
rology 2002;58:1726-38
26. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman
BL, Lipp R. New Ballard score, expanded to include ex-
tremely premature infants. J Pediatr 1991;119:417-23
Published
2016-10-10
How to Cite
1.
Firman K, Amir I, Kurniati N, Sastroasmoro S. Periventricular leucomalacia in premature infants in neonatal ward, Cipto Mangunkusumo Hospital: A preliminary study. PI [Internet]. 10Oct.2016 [cited 23Apr.2024];44(3):122-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/749
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Received 2016-09-30
Accepted 2016-09-30
Published 2016-10-10
Accepted 2016-09-30
Published 2016-10-10
