USE OF PRENATAL PHENOBARBITAL IN THE PREVENTION OF SUBEPENDYMAL INTRAVENTRICULAR HEMORRHAGE IN PREMATURE-INFANTS/

Background: Subependymal/intraventricular hemorrhage (SE/IVH) is a fre quent cause of disability and mortality, Methods: This is a prospectiv e, randomized, double-blind study which included 100 pregnant Mexican women who need to interrupt their pregnancy within 28 - 32 weeks of ge station, One group was given a single dose of intravenous (IV) phenoba rbital 10 mu g/kg (phenobarbital group, n = 50), and the other was pro vided with diluted distilled water (control group). Measurements of ph enobarbital serum concentrations were taken by both mother and newborn , and head sonograms were applied during the first 24 hours, at the 3r d and 7th days of life. Results: The sample was made up of 42 newborns in the phenobarbital group, and 46 in the control group; the newborns had phenobarbital levels of 11.5 5.7 g/mu l at birth, and of 9.5 +/- 5.9 g/mu l 24 hours later. SE/IVH was found in 12 patients from the ph enobarbital group and in 29 from the control group (p<0.005), the firs t group were 11 mild SE/IVH (2 grade I, and 9 grade II), and 26 in the control group (4 grade I, and 22 grade II), p<0.005. Severe hemorrhag es mere similar between groups, A larger frequency of SE/IVH was found in the newborn group which received mechanical ventilation (p = 0.000 8). Conclusions: Prenatal phenobarbital can reduce the SE/IVH frequenc y in premature infants younger than 32 weeks at birth, Its main effect could be shown in patients with mechanical ventilation.