29.     Neonatal intraventricular haemorrhage:  

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a. is associated with prematurity True
b. occurs in about 50% of very low birth weight babies True
c. usually occurs in the early days of life True
d. is diagnosed by lumbar puncture False
e. may lead to hydrocephalus True
f. is prevented by vitamin K False

IVH is particularly associated with prematurity.

It occurs in up to 50 percent of babies of <1,500 gm. birthweight and is rare in mature babies.

Other risk factors are respiratory distress syndrome and the need for ventilatory support, hypercapnia and metabolic acidosis.

Coagulation defects also contribute.

Most affected babies have minimal clinical signs.

At the other extreme, the haemorrhage may extend into the substance of the cerebral tissue with massive damage.

About 40% of babies will show signs of ventricular dilatation.

The diagnosis is by ultrasound.

The only intervention which has been shown to be helpful is the use of ante-natal steroids.

A stack of other treatments are under trial, e.g. ethamsylate, NSAIs. etc.

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