Successful management by recombinant activated factor VII in a case of disseminated intravascular coagulopathy caused by obstetric hemorrhage.

Abstract

Postpartum hemorrhage (PPH) is a life-threatening emergency in obstetrics. Although recombinant activated factor VII (rFVIIa) has become used for the treatment of some cases of massive hemorrhage, its applications in the field of obstetrics are still limited. We describe a case of successful treatment with rFVIIa for PPH due to placenta accreta. The patient was a 33-year-old woman with placental previa. Cesarean section (CS) was performed at gestational week 35. During CS, there was massive hemorrhage due to placenta accreta. After CS, disseminated intravascular coagulopathy and hypovolemic shock were diagnosed. The PPH was not controlled by transfusion therapy. On the fourth day after CS, rFVIIa (90 microg/kg x 2) was given because of the persistent PPH. Bleeding decreased and no further transfusion was required from 2 days after administration. rFVIIa was useful in the treatment of this case of obstetric hemorrhage.

• Authors: Tomoyoshi Nohira, Yumi Osakabe, Shingo Suda, Chie Takahashi, Asashi Tanaka, Kazumi Ikeda, Toshiaki Ikeda, Kazuhiro Okabe
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 34 Issue 4 Pt 2 Pg. 623-30 (Aug 2008) ISSN: 1341-8076 [Print] Australia
• PMID: 18840167 (Publication Type: Case Reports, Journal Article)

Chemical References

• Recombinant Proteins
• recombinant FVIIa
• Factor VIIa

Topics

• Adult
• Disseminated Intravascular Coagulation (drug therapy, etiology)
• Factor VIIa (therapeutic use)
• Female
• Hematologic Tests
• Humans
• Placenta Accreta (diagnosis)
• Postpartum Hemorrhage (drug therapy)
• Pregnancy
• Recombinant Proteins (therapeutic use)