Ethamsylate in the Prevention of Patent Ductus Arteriosus

Abstract

Patent ductus arteriosus (PDA) is common in premature infants younger than 33 weeks' gestational age (GA), and its deleterious effects are increased by the presence of respiratory distress syndrome. A significant proportion of infants younger than 33 weeks' GA have PDA. 12 Indomethacin has been used for the treatment of hemodynamically significant ductus, causing severe side effects, but even recently, it has been considered the only pharmacological approach to PDA. 3 In the early 1980s, Morgan et al 4 reported a reduction in the incidence of intraventricular hemorrhages in preterm neonates treated with ethamsylate, an inhibitor of prostaglandin biosynthesis. 4-6 Recently, ethamsylate has been reported to favor the closure of the ductus in preterm neonates with respiratory distress syndrome treated with exogenous surfactant. 7 In 1987, we started prophylaxis of cerebral hemorrhages with ethamsylate (50 mg/kg per day in four intramuscular injections for 4 days, from the first day of