What is an IVH (intraventricular hemorrhage)?

IVH stands for intraventricular hemorrhage, which means bleeding inside the brain, in the fluid-filled spaces called the ventricles.

This type of bleeding happens mostly in very premature babies, especially those born before about 32 weeks, because their brains are still very delicate.

Why does it happen?

Inside the brain of a preterm baby is an area called the germinal matrix.This area has:

• Very fragile blood vessels

• A lot of blood flow

• Less protection than a full-term baby’s brain

Because of this, even small changes—like changes in blood pressure, oxygen levels, or handling—can sometimes cause those vessels to break and bleed.

Are there different levels of IVH?

Yes. IVH is graded from 1 to 4, based on how much bleeding there is:

• Grade 1: A small bleed in the germinal matrix

• Grade 2: Bleeding inside the ventricles, but they aren’t enlarged

• Grade 3: Bleeding that makes the ventricles larger

• Grade 4: Bleeding that has spread into the brain tissue around the ventricle

Speak to your baby's healthcare provider to ask them more about possible long term effects of your baby's IVH.

How do you check for IVH?

Most preterm babies get an ultrasound of the head in the first week of life.This is:

• Safe

• Painless

• Done at the bedside in the NICU

Ultrasounds can help to see if there is any bleeding in the ventricles.

When are the ultrasounds done?

Typically the first ultrasound is done within the first few days of life. The next ultrasound is typically about 1 week later. The medical team will determine how many ultrasounds your baby needs based on their gestational age at birth and whether they see an IVH that needs to be followed.