Antepartum Vitamin K and Phenobarbital for Preventing Intraventricular Hemorrhage in the Premature Newborn: A Randomized, Double-Blind, Placebo-Controlled Trial

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Abstract

Objective:

To determine whether antepartum phenobarbital and vitamin K reduce the risk of intraventricular hemorrhage in premature newborns.

Methods:

Patients at imminent risk for spontaneous or indicated premature delivery between 24-34 weeks' gestation were randomized to receive either placebo or vitamin K and phenobarbital. All patients received betamethasone and antibiotics and were managed uniformly by a single perinatal group in one hospital. All newborns were managed uniformly in the same facility by a single neonatal group.

Results:

There was a nonsignificant reduction in all grades of intraventricular hemorrhage in the treatment group when compared to the placebo group (48.2 versus 38.3%; P> .05). Frequencies were reduced for severe intraventricular hemorrhage (grades 3 and 4) (6.0 versus 2.5%; P> .05) and mild intraventricular hemorrhage (grades 1 and 2) 42.2 versus 35.8%; P>.05).

Conclusions:

Antepartum phenobarbital and vitamin K effected a nonsignificant reduction in both mild and severe intraventricular hemorrhage. The incidence of severe intraventricular hemorrhage in our control group was significantly less than that observed in previous studies.

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