Intraventricular hemorrhage, or IVH, is bleeding into the fluid-filled spaces of a newborn’s brain and typically occurs in the first few days after birth. IVH is most often seen in premature babies, especially those born very early or at very low birth weight.
While mild cases can cause a few lasting problems, the more serious cases involve bleeding, which can place pressure on brain tissue, leading to more dangerous complications.
Symptoms of IVH
Many present don’t display symptoms of IVH right away, which makes knowing what to look for even more critical, as how quickly a baby is treated for IVH greatly impacts how severe the injuries are.
Some of the more common symptoms of IVH are:
- Breathing pauses (apnea).
- Changes in blood pressure or heart rate.
- Decreased muscle tone.
- Decreased reflexes.
- Excessive sleepiness.
- Lethargy.
- Weak suck or feeding difficulty.
- Seizures or other abnormal movements.
Injuries caused by IVH
Depending on the severity of the bleed, injuries caused by IVH range from mild to severe. One of the most serious injuries is hydrocephalus, which happens when fluid builds up in the brain and creates pressure. That pressure may require surgery to place a shunt that drains the fluid in hopes of preventing further brain damage.
IVH is also known to cause cerebral palsy, which impacts the baby’s movement, muscle control, and coordination. Babies who suffer from cerebral palsy may have problems with walking, maintaining balance, or using their hands.
Brain injuries are known to affect learning and development in children. These issues can include delays in speech, difficulty with memory, or trouble focusing in school. In the most severe cases, the victim may develop intellectual disabilities that require long-term educational support.
IVH has also been linked to vision and hearing problems, which may not be noticeable until the child begins to develop. Some victims also struggle with seizures, which can require ongoing medical treatment and monitoring.
How medical malpractice can cause IVH
When healthcare staff fail to meet the accepted standard of care, it may be considered medical malpractice. That’s especially true if the mistake caused or worsened an existing condition. While not all cases of IVH are caused by negligence, substandard care can certainly contribute to it.
Examples of substandard care include:
- Failure to properly monitor and manage high-risk pregnancies.
- Failure to prevent or appropriately respond to premature labor.
- Failure to administer antenatal corticosteroids when preterm birth is expected.
- Delaying a medically necessary C-section.
- Failure to recognize fetal distress during labor and delivery.
- Improper or delayed neonatal resuscitation after birth.
- Failure to maintain stable oxygen levels (oxygen deprivation).
- Poor management of blood pressure in a fragile, premature infant.
- Rough or improper handling/transport of a medically unstable newborn.
- Failure to perform timely cranial ultrasound screening for IVH.
- Failure to monitor for or recognize signs of worsening brain bleeding.
- Delayed diagnosis or failure to treat hydrocephalus (fluid buildup in the brain).
- Failure to transfer the baby to a facility with appropriate NICU-level care.
Contacting the team at Weisser Law is the best step you can take to ensure medical records are reviewed correctly to determine whether malpractice was committed.
Intraventricular Hemorrhage (IVH) in Newborns FAQs
What newborns are most at risk for IVH?
Babies who are born very prematurely are at the highest risk of suffering from IVH. That’s especially true before 30 to 32 weeks of pregnancy and babies with very low birth weight. Babies who are born more than 10 weeks early are at an increased risk because their blood vessels in the brain are not fully developed.
Risk increases when the baby has respiratory distress syndrome, unstable blood pressure, or other serious medical issues at birth. That’s why NICU monitoring and early screening are so vital for these babies.
What do the grades of IVH mean?
Cases of IVH are graded on a scale that identifies the severity of the bleed. Grades 1 and 2 are considered smaller bleeds that generally have a better chance of recovery with minor impact on the baby. Grades 3 and 4 are much more serious and can cause lifelong injury.
Grade 3 means the blood is causing pressure within the ventricles, while grade 4 means the bleeding is also affecting brain tissue.
By assigning grades, doctors can better explain how serious the injury is, the type of monitoring needed, and whether the baby is at higher risk of developmental or neurologic complications later on.
What Is the Difference Between Intracranial Hemorrhage and Intraventricular Hemorrhage in Newborns?
In the most simple terms, all intraventricular hemorrhages (IVH) are intracranial hemorrhages, but not all intracranial hemorrhages are intraventricular.
Intracranial hemorrhage is a broad term that applies to any bleeding inside a baby’s skull. The bleed can happen in different areas of the brain, including in the brain’s ventricles, tissue, or generally around the brain.
On the other hand, IVH refers to a specific type of brain bleed that starts in a fragile part of the brain, known as the germinal matrix. From there, the bleed spreads into the ventricles. IVH is most common in premature babies as their brain blood vessels are not fully developed.
The distinction between the conditions is important because the location and severity of a brain bleed affect both the treatment and long-term outcome for patients.
Can IVH be prevented?
Not always, but there are steps that healthcare providers can take to reduce the risk. Pregnant women at high risk of early delivery can be given corticosteroids that lower the risk of IVH in the baby. Antenatal corticosteroid therapy reduces neonatal complications, including intracranial hemorrhage.
Delaying cord clamping is known to lower the risk of IVH in premature babies. Umbilical cord milking has been linked to an increased IVH risk in extremely preterm infants when compared to delayed clamping.
What should parents ask if their baby is diagnosed with IVH?
It’s very important that parents ask what grade of IVH their baby has. They should also ask whether there are any signs of hydrocephalus — a buildup of cerebrospinal fluid (CSF). Parents should ask what the MRI or ultrasound is showing, what monitoring is needed, and what the doctors expect in the short term.
Because IVH changes over time, it’s critical that families understand the plan for repeating imaging and the follow-up. Many NICUs follow the progress of babies with IVH for years, as early intervention services could be needed to support the baby’s development.
Why Should Parents Contact Weisser Law If They Suspect IVH Was Caused by Medical Malpractice?
Our firm has decades of experience fighting for families whose child was injured by medical mistakes. These cases are very complex and require a deep understanding of how the standard of care is supposed to go. Our nurse consultants spent years working in delivery rooms, meaning they know what proper care is supposed to look like, and more importantly, what a mistake looks like.
Weisser Law understands how to analyze medical records, identify missed warning signs, and determine whether proper care was provided during pregnancy, labor, delivery, and the newborn period.
By contacting Weisser Law right away, we can also preserve critical evidence such as fetal monitoring strips, imaging, and NICU records. These critical pieces of evidence can make or break your case.
Our team will fight tirelessly to ensure your family is compensated for not just the injury, but for any lifelong care, therapy, and medical needs your child may require for their life. Weisser Law offers free consultations and works on a contingency basis, meaning you don’t pay until we win.