Retinopathy of Prematurity/ Periventricular–Intraventricular Hemorrhage

ROP

Retinopathy of prematurity; a potentially blinding retinal vascular eye disease occurring in very-low-birth-weight and preterm infants.

Risk Factors for ROP

Major risk factors include supplemental oxygen, low birth weight, multiple births, white race, mechanical ventilation, and early gestational age.

Incidence of ROP

The incidence of ROP is inversely proportional to birth weight in preterm newborns; about 1,400 to 1,600 develop ROP needing treatment annually in the US.

Stages of ROP

ROP is classified into five stages, from mild (stage I) to severe (stage V), based on severity, location in the retina, and extent of retinal circumference.

Pathophysiology of ROP

In preterm infants, interrupted normal blood vessel development due to lack of oxygen leads to abnormal vessel formation and potential blindness.

Vitreous Hemorrhage

Bleeding into the vitreous cavity of the eye; can result from abnormal blood vessels in ROP.

Preventive Measures for ROP

Important strategies include minimizing risk factors for preterm birth and careful monitoring of oxygen levels in at-risk infants.

Laser Photocoagulation Therapy

A surgical intervention for advanced stages of ROP that destroys abnormal blood vessels and seals leaks.

PVH–IVH

Periventricular-intraventricular hemorrhage; a condition in preterm infants characterized by bleeding in the brain, associated with neurodevelopmental issues.

Gestational Age and IVH Incidence

The incidence of ventricular hemorrhage increases in preterm infants, particularly those born before 30 weeks' gestation.

Indicators of PVH–IVH

Signs include unexplained drop in hematocrit, respiratory distress, seizures, and changes in level of consciousness.

Prognosis of PVH–IVH

Prognosis is guarded, with better developmental outcomes generally seen in milder cases (grades I and II) than in severe cases (grades III and IV).

Nursing Management for ROP

Involves screening at-risk newborns, providing prenatal education, and implementing oxygen therapy protocols.

Support for Families of Infants at Risk for ROP

Providing emotional support and education about the newborn’s condition and treatment options is essential for families.

Long-term Follow-Up for ROP

Newborns with ROP are at risk for various visual and neurological problems, necessitating ongoing follow-up care.

Antecedent Causes of PVH–IVH

Causes include fluctuations in blood flow, maternal factors like infection, and lack of prenatal care.

Brain Injury from PVH–IVH

Complications can lead to conditions like cerebral palsy, developmental delays, and other neurologic deficits.