Developmental supportive techniques to reduce intraventricular hemorrhage in preterm infants

Background and Aim : Intra ventricular hemorrhage is a serious and common problem in premature and low birth weight infants due to factors such as respiratory distress, blood pressure changes, pneumothorax, and so on. It results in irreversible neurodevelopmental deficits that are associated with high mortality rates. However, in many cases it is preventable even before the infant is born. This study was performed to evaluate the Development supportive techniques available to reduce intra ventricular hemorrhage in preterm infants based on the results of studies.Methods : In this review study, information was collected between 2005 and 2019 through a review of related literature and articles and a targeted search for information sources in English and Persian articles and databases. The keywords were neurodevelopment, premature infants, neonatal intensive care units, intra ventricular hemorrhage. Of the 68 articles found, 20 were eligible.Results : Prevention of intra ventricular hemorrhage in preterm infants begins from fetal period with prenatal care to improve fetal weight gain, control of blood pressure and maternal blood glucose, treatment of pregnancy infections, stress reduction, rest and proper nutrition to prevent delivery early. The delivery process should be monitored to ensure that the infant is not hypoxic. After birth, care program continues with a medical approach with complementary therapies and developmental supportive techniques. These include tactile or massage therapy, use of neonatal positioning, reduction of environmental stimuli such as light and relaxation of the environment, and maintenance of natural temperature, with particular attention to the neonatal sleep cycle, especially REM, for neurodevelopment and vision, minimization Painful procedures, non-feeding sucking, Kangaroo mother care, monitoring and interpreting infant behavior, and training parents and developmental care programs. These methods ensure energy conservation for the proper brain development and physiological stability of the infant, minimize the stress and pain of the infant, minimize brain circulation and arterial oxygen saturation, and reduce intra ventricular hemorrhage.Conclusion : Promoting neonatal neurodevelopment, as a treatment priority, is possible by preventing intra ventricular hemorrhage. This will be achieved if a neonatal-family-based care approach is planned along with ongoing follow-up from admission to the neonatal intensive care unit until after discharge. Therefore, an individualized developmental care and assessment program should be based on a comprehensive understanding of the infant s and family s circumstances (strengths, weaknesses, opportunities and threats) and that requires strong collaboration between the care team.

کلیدواژه ها:

Intra ventricular hemorrhag ، Premature infant ، Neurodevelopment