الفهرس 
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Abstract
Preterm birth is defined as any birth before completed 37 weeks gestation. It affects approximately 11% of births worldwide. Although the majority of preterm births occur in women without a clear cause, many risk factors may cause preterm birth such as; maternal hypertension, maternal diabetes, medical practices (e.g. provider-initiated delivery, assisted reproduction), maternal socio-demographic and lifestyle characteristics and environmental factors. Intraventricular hemorrhage (IVH) is the most common type of intracranial hemorrhage, especially in extremely preterm infants. Consequences in survivors of severe IVH may include post hemorrhagic hydrocephalus, seizures, cerebral palsy, and cognitive delay. Advances in obstetrics and neonatal care over the last decades have led to a steady decline in mortality of premature infants. This improvement in survival, along with increased preterm birth rates, has resulted in an increase in newborns prone to IVH and its complications. Therefore, the number of newborns surviving with severe IVH and at risk for long-term neurological sequelae remains high. The incidence of significant IVH (grade III and IV) in preterm neonates born ≤ 29 weeks gestational age (GA) ranges from 10 to 16%. Neonates with significant IVH are at highest risk for developing progressive post hemorrhagic ventricular dilatation (PHVD) which is a major risk factor for adverse neurodevelopmental outcome. A recent Canadian cohort study of preterm infants < 29 weeks identified severe brain injury as the strongest independent predictor of adverse neurodevelopmental outcome. The etiology of IVH is complex and multifactorial and includes perinatal factors such as, prolonged rupture of membranes, chorioamnionitis, need for aggressive resuscitation, and postnatal factors such as hypothermia, hypercapnia, early onset sepsis, and need for reintubation in the first 72 hours of life. Acute brain injury is primarily attributed to the intrinsic fragility of the germinal matrix vasculature and the disturbance in cerebral blood flow inherent to extremely premature birth. Up to 40% of hemodynamic instability in these fragile infants is treated with inotropes. The main aim of this study was to evaluate the occurrence of Intraventricular hemorrhage in preterm infant with the use of inotropes. This Prospective case control study was carried out on 50 preterm neonates who were admitted at the Neonatal Intensive Care Unit (NICU), Pediatric department, Tanta University Hospitals. The studied patients were divided into two groups. group A: (case); 25 patients received inotropic support in the 1st week of life when indicated. group B: (control); 25 patients not received inotropic support. Cranial us was done at day one and day seven post natal life and after initition of intropes when indicated.