Babies who have mild bleeds usually do not show any signs and the bleed will only be diagnosed on routine screening ultrasound scans. Babies who develop severe bleeds may occasionally be unwell, with changes in their breathing pattern, blood pressure and behaviour.

​The blood vessels in the premature brain are fragile and are prone to bleeding into the ventricular spaces, and if more severe, into the brain tissue itself. The more immature or the more unstable the baby's clinical condition is during the first few days, the higher the chances of bleeding.

​Intraventricular hemorrhage (IVH) is one of the conditions affecting babies with very low birth weight (VLBW). The degree of bleeding can be divided into four grades: grade 1 to 4 (increasing in size and severity). Grade 3 and Grade 4 bleeds are classified as severe IVH. Grade 4 bleeds will have the greatest risk of affecting the future mental and physical development of the baby.

​Diagnosis is done using ultrasound. The ultrasound probe is placed on the soft part of the skull called the anterior fontanelle.  Routine ultrasound scans are performed for all babies born below 1,500g, several times during the baby's stay.

No specific treatment is available for most cases of bleeding.  In severe cases, the blood in the ventricles may obstruct the flow of cerebrospinal fluid (brain fluid) and lead to hydrocephalus (dilation of the ventricles). This may require drainage and removal by our doctors.

Premature babies with severe grades of IVH are followed up after discharge in our high-risk neonatal clinics.  We can provide early intervention with the support of the physiotherapist and occupational therapist.

The Early Starter Club is a support group for parents of premature babies in our NICU.

​In our VLBW cohort (2015-2019), our rate of severe IVH is 3.7% as compared to the Vermont Oxford Network rate of 8.9% in 2015.

Information is correct as of December 2019.