Role of ethamsylate in preventing periventricular-intraventricular hemorrhage in premature infants below 34 weeks of gestation.
OBJECTIVE
To determine the role of ethamsylate in prevention of PVH-IVH in premature infants <34 weeks gestational age.


METHODS
Prospective, randomized, controlled study.


METHODS
Infants less than 34 weeks gestational age were included in the trial. Neonates with congenital malformations, family history of bleeding disorders and with Apgar scores <5 at 5 minutes were excluded. Subjects were randomized into two groups--Group A infants received intravenous ethamsylate (12.5 mg/kg) six hourly for four days and Group B infants served as a control group. Regular cranial ultrasounds to detect the presence of PVH-IVH were done between days 3-5, 10-14 and 28-30 of post natal age, and before hospital discharge in all infants and weekly in infants detected to have PVH-IVH on earlier scans. Various antenatal and postnatal factors known to affect the incidence of PVH-IVH were recorded.


RESULTS
A total of 192 infants underwent the trial, 93 in Group A and 99 in Group B. Antenatal corticosteroids (1 or 2 doses) were administered to 32 ( 34.4%) and 36 (36.3%) women in Group A and Group B, respectively. None of the mothers received phenobarbitone, vitamin K or indomethacin antenatally and none of the infants received phenobarbitone, vitamin E or indomethacin postnatally during the study period. PVH-IVH was seen in 26 infants in Group A, of which Grade I IVH occurred in 9, Grade II in 14, Grade III in 2 and Grade IV in one infant. Twenty-nine infants had PVH-IVH in Group B of which 11 had Grade I, 15 Grade II and 3 Grade III. None of the differences were statistically significant.


CONCLUSIONS
Postnatal administration of ethamsylate did not decrease the incidence of PVH-IVH in the study infants.
Sanghvi
K P
KP
Nowrosjee Wadia Maternity Hospital, Acharya Donde Marg, Parel, Mumbai 400 012, India.
Merchant
R H
RH
Karnik
A
A
Kulkarni
A
A
D002543:Cerebral Hemorrhage / Q000517:prevention & control*; D002552:Cerebral Ventricles; D004979:Ethamsylate / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male
D006490:Hemostatics; D004979:Ethamsylate