Bаby L, а 26‑week, 870‑grаm infant, was bоrn fоllоwing preterm labor and premature rupture of membranes. The mother received no antenatal steroids. Shortly after birth, the infant requires intubation and mechanical ventilation. During the first day of life, Baby L experiences hypotension, requiring a normal saline bolus and low‑dose dopamine.At 20 hours of life, the bedside nurse reports apnea, decreased responsiveness, and a tense, bulging fontanelle. Cranial ultrasound shows a right‑sided Grade III intraventricular hemorrhage with early ventricular dilation. Which mechanism best explains why extremely preterm infants are at high risk for IVH?
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