Intraventricular Hemorrhage in Newborns

What Is an Intraventricular Hemorrhage?

An intraventricular hemorrhage (in-treh-ven-TRIK-yeh-ler HEM-er-idge) is bleeding in and around the brain's ventricles. The ventricles are spaces in the brain filled with cerebral spinal fluid.

What Are the Signs & Symptoms of an Intraventricular Hemorrhage?

Doctors use grades to classify an intraventricular hemorrhage (IVH), from grade 1 to 4. Grades are based on the amount and location of bleeding in the brain. A grade 1 or grade 2 IVH can be mild and cause few or no problems. Grade 3 and grade 4 IVHs have more bleeding and can be very serious.

Babies with a minor IVH often have no symptoms. Babies who have an IVH with more serious bleeding can have:

• pauses in breathing (apnea)
• a slow heart rate
• anemia
• bulging at the "soft spot" on the baby's head (the fontanel)
• seizures
• a weak suck and poor feeding
• irritability

What Causes an Intraventricular Hemorrhage?

Babies who are born early are more likely to develop an IVH. Those born very early or who are very small are at greatest risk.

Blood vessels in babies born very early are not fully developed. Problems from an early birth — such as low oxygen levels, changes in blood pressure, and breathing problems — can damage these fragile blood vessels, making them leak.

Other reasons a baby might get an IVH include:

• a low birth weight (3 pounds or less)
• a difficult delivery
• bleeding problems
• an infection in the baby's mother

How Is an Intraventricular Hemorrhage Diagnosed?

Most IVHs happen within the first few days of life. Doctors use an ultrasound scan of the head to diagnose the problem when a baby:

• is born early
• is born after a difficult delivery
• has symptoms of an IVH
• has risk factors for an IVH, such as needing breathing help from a ventilator

How Is an Intraventricular Hemorrhage Treated?

There is no specific treatment for an IVH. Newborns who have one are cared for in a neonatal intensive care unit (NICU). A team of experts, including nurses and doctors who specialize in newborn care, will watch for and treat any problems related to the IVH and early birth.

A baby with severe IVH may develop hydrocephalus, a buildup of extra fluid in the brain's ventricles. Doctors will do head ultrasounds regularly to look for this problem. To drain the fluid and relieve pressure in the brain if it does happen, doctors can:

• place a VP shunt
• do a spinal tap

Most babies with a mild IVH do well. Babies born very early or who have a more severe IVH are at risk for cerebral palsy, seizures, developmental delays, and learning problems.

What Else Should I Know?

Preventing premature birth is the best way to prevent an intraventricular hemorrhage. Doctors can give steroid medicines to pregnant women who are likely to deliver their babies early. Steroids help the baby's lungs mature and decrease the chances of an IVH. Delayed cord clamping at delivery also may help prevent it.

If your baby is born early, reach out to the NICU team for support. They are there to help your baby and you. You also can find support and information online at:

• March of Dimes NICU Family Support
• Support 4 NICU Parents
• Graham's Foundation