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ANTENATAL PHENOBARBITAL FOR PREVENTION OF NEONATAL INTRAVENTRICULAR HEMORRHAGE: PRELIMINARY OBSERVATIONS

Eighteen mothers in premature labor <35 week gestation were enrolled in a study to evaluate the effect of antenatal phenobarbital(PB) in preventing neonatal intraventricular hemorrhage.Mothers were randomly assigned to treatment or control groups; the treatment group received 500 mg PB administered intravenously.Maternal and cord blood PB levels were measured at delivery. Echoencephalograms were performed on days 3 and 14 and hemorrhage graded as mild, moderate and severe.Nine mothers(including one multiple pregnancy) received antenatal PB. Mean time between administration of PB and delivery was 2.9±2.7 hours. Maternal PB levels at delivery were 9.2±2.3 μg/ml. Cord blood PB levels were 9.8±2.1 μg/ml. The PB and control groups were comparable regarding maternal age,duration of rupture of membranes, route of delivery, presentation, birth weight,gestational age,Apgar scores and incidence of pneumothoraces, hypotension,acidosis, hypoxemia,hypercarbia or amount of fluid intake or bicarbonate therapy during the first 3 days. Seven of 10 infants in the PB group had no hemorrhage while 1 had a mild and 2 had severe hemorrhages. Five of 9 infants in the control group had no hemorrhage while 2 had moderate and 2 had severe hemorrhages. When comparing mild or no hemorrhage vs moderate and severe hemorrhage in the 2 groups no significant difference has been found thus far (p = .21).