Intraventricular Hemorrhage Of Infancy
(IVH; Subependymal Germinal Matrix Hemorrhage; Early-onset Germinal Matrix Hemorrhage; EGMH; Periventricular-Intraventricular Hemorrhage; PIVH)
Intraventricular hemorrhage (IVH) is bleeding into the spaces of a baby’s brain. IVH is most common in premature babies.
IVH may cause damage to brain tissue and lead to long-term development problems.
Ventricles of the Brain
IVH is caused by the rupture of immature or fragile blood vessels in the brain. It is not clear why this happens but changes in blood pressure may play a role.
Factors that increase your baby’s chance of developing IVH include:
- Low birth weight
- Lack of oxygen
- Direct trauma to the baby’s head during birth
- Breathing complications at birth
- Infection that leads to blood clotting problems
- Severe infection
It often occurs in the first 48 hours after birth. In many cases, there are no visible signs of IVH. Symptoms that may occur include:
- Swelling of soft spots at the top of the head
- Pauses in breathing
- Muscle spasms
- Pale or blue color
- Weak suck
A physical exam will be done. The doctor will look for any signs of a brain injury.
An ultrasound will be used to make images of the brain structures, blood vessels, and blood flow in the brain.
Other tests, like blood tests, may be done to look for anemia and causes of the bleeding.
In most cases, the bleeding gradually stops. Treatment options include:
- Monitoring your baby’s condition to manage any complications.
- Treating any other medical conditions associated with the bleeding.
Certain procedures or surgery may need to be done to relieve pressure in the brain:
- Ventriculoperitoneal shunt—a tube that runs under the skin and allows fluid to drain from the ventricle (brain) to the abdomen
- Lumbar puncture, fontanelle tap, or surgery—to drain fluid from your baby's brain
If you are at risk of having a premature baby, you may be given medication to decrease the chance of IVH.
American Academy of Neurology
Healthy Children—American Academy of Pediatrics
Canadian Pediatric Society
Ballabh P. Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatr Res. 2010;67(1):1-8.
Intraventricular hemorrhage. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/health-topics/conditions/intraventricular-hemorrhage. Accessed September 15, 2015.
Intraventricular hemorrhage of infancy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116485/Intraventricular-hemorrhage-of-infancy. Updated April 3, 2014. Accessed September 15, 2015.
Fowlie PW, Davis PG, McGuire W. Prophylactic intravenous indomethacin for preventing mortality and morbidity in preterm infants. Cochrane Database of Syst Rev 2010;7:CD000174.
Last reviewed September 2015 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.