Severe intracranial hemorrhages are not rare in extremely preterm infants. They occur early, generally when babies require life-sustaining interventions. This may lead to ethical discussions and decision-making about levels of care. Prognosis is variable and depends on the extent, location, and laterality of the lesions, and, importantly also on the subsequent occurrence of other clinical complications or progressive ventricular dilatation. Decision-making should depend on prognosis and parental values. This article will review prognosis and the uncertainty of outcomes for different lesions and provide an outline of ways to conduct an ethically appropriate discussion on the decision of whether to continue life sustaining therapy. It is possible to communicate in a compassionate and honest way with parents and engage in decision-making, focussing on personalized information and decisions, and on function, as opposed to diagnosis.

严重颅内出血在极度早产儿中并不少见。它们发生得很早，通常在婴儿需要维持生命的干预措施时发生。这可能会引发关于护理水平的伦理讨论和决策。预后是可变的，取决于病变的范围、位置和偏侧性，重要的是还取决于随后发生的其他临床并发症或进行性心室扩张。决策应取决于预后和父母的价值观。本文将回顾不同病变的预后和结果的不确定性，并概述就是否继续生命维持治疗的决定进行伦理上适当的讨论的方法。有可能以富有同情心和诚实的方式与父母沟通并参与决策，