Prematurely born infants are at risk of bleeding into the brain in the first few weeks of life. This is called intraventricular haemorrhage. The risk of this occurring is greatest to infants who are born less than 32 weeks gestation. Many potential therapies have been studied to determine if they might reduce the risk of this bleeding. One such therapy is a drug called Ethamsylate. It is not exactly known how this drug works, but it appears to reduce bleeding in other clinical situations, such as excessive menstrual bleeding and after some types of surgery.
A total of seven studies with 1410 preterm infants were included in this review. Most of these initial studies were conducted between 1980 and 1990. Preterm infants treated with ethamsylate had similar outcomes with respect to death and disability at the age of two years when compared to infants who were treated with a placebo. Infants born less than 35 weeks gestation appeared to have less intraventricular haemorrhage when treated with ethamsylate compared to controls, however this did not lead to improved developmental outcome in later childhood. There were no adverse effects noted with ethamsylate treatment.
Based on these results, routine use of ethamsylate for prematurely born infants to prevent intraventricular haemorrhage cannot be recommended. It is highly unlikely that any further trials will be conducted to explore this clinical question.