The role of recombinant factor VIIa for obstetric block in women with severe factor XI deficiency.

Abstract

Regional blocks like spinal, epidural and combined spinal epidural (CSE) are relatively contraindicated in individuals with bleeding disorders. Consequently pregnant women with severe factor XI (FXI) deficiency are often denied this option during labour and caesarean section. We describe three women with severe FXI deficiency in whom regional block was performed with low-dose recombinant factor VIIa (rFVIIa) for their operative procedures during delivery. All women achieved haemostasis and had uncomplicated regional block, delivery and surgical procedures. The point of care device--rotational thromboelastometry (ROTEM) was used to monitor the patients' coagulation and determine the dose of rFVIIa to achieve in vitro haemostasis in these women that was then subsequently used in vivo. Low-dose rFVIIa seems to be effective and safe in the management of delivery and enables provision of regional blocks in women with severe FXI deficiency.

• Authors: S Setty, A Reddell, A England, K Gomez, R Kadir
• Journal: Haemophilia : the official journal of the World Federation of Hemophilia (Haemophilia) Vol. 17 Issue 6 Pg. 906-9 (Nov 2011) ISSN: 1365-2516 [Electronic] England
• PMID: 21453421 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Coagulants
• Recombinant Proteins
• recombinant FVIIa
• Factor VIIa

Topics

• Adult
• Anesthesia, Epidural
• Blood Loss, Surgical (prevention & control)
• Cesarean Section
• Coagulants (administration & dosage)
• Factor VIIa (administration & dosage)
• Factor XI Deficiency (blood, drug therapy)
• Female
• Hemostasis, Surgical (methods)
• Humans
• Pregnancy
• Pregnancy Complications, Hematologic (prevention & control)
• Recombinant Proteins (administration & dosage)
• Treatment Outcome