A 28-week preterm infant is being monitored for intraventricular hemorrhage (IVH). Cranial ultrasound on day 5 shows blood in the germinal matrix extending into the ventricle, which is dilated. This corresponds to which grade of IVH according to the Papile classification?
- A Grade I
- B Grade III ✓
- C Grade II
- D Grade IV
Correct answer: B. Grade III
Explanation
The Papile grading system classifies IVH as: Grade I — subependymal/germinal matrix only; Grade II — IVH without ventricular dilation; Grade III — IVH with ventricular dilation; Grade IV — IVH with periventricular hemorrhagic infarction (formerly called parenchymal extension). The described finding of intraventricular blood with ventricular dilation fits Grade III. Grade IV carries the worst prognosis for neurodevelopmental outcomes. Grade III has moderate long-term neurodevelopmental risk.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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