Objective Intraventricular haemorrhage (IVH) is a major problem in premature infants. Our objective is to assess the early predictive value of vascular endothelial growth factor (VEGF) for development of IVH and management of its squeal in preterm neonates.
Methods We prospectively studied 150 preterm neonates (PT) less than 34 weeks gestation. Fifty of them completed the study. 30/50 developed IVH during follow up, and 20 did not. First 24 hours, and 3rd day serum samples were collected. Cerebrospinal fluid (CSF) samples were withdrawn for 10 IVH patients.
Results Serum VEGF; both samples were increased in IVH compared to non-IVH group, (P=0.001). PHVD-group (n=10) had higher VEGF in both samples than resolved IVH (P=0.004),(P=0.005). While, VEGF increased in the IVH group 2nd sample compared to 1st (P=0.000), it decreased in non-IVH group, P=0.033). Each 1 unit increase in 1ST VEGF increased the risk of occurrence of IVH by 1.6%. 3rd day VEGF at a cut-off value of 135pg/ml is 96% sensitive and 100 specific to predict post haemorrhagic ventricular dilatation (PHVD). Serum VEGF inversely correlated with TLC, pH, PO2 and HCO3, and positively correlated with PCo2 and FiO2.
Conclusion Serum VEGF predicts development of IVH and PHVD in PT neonates. Also, high CSF level of VEGF could predict the need for permanent shunt placement.
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