Obstetrics and gynecology · 2006
Factor VIIa in puerperal hemorrhage with disseminated intravascular coagulation.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Pepas Litha P, Arif-Adib Merhnoosh, Kadir Rezan A
Аннотация
BACKGROUND: [corrected] Puerperal hemorrhage associated with disseminated intravascular coagulation is a life-threatening obstetric emergency. Recombinant factor VIIa is a novel hemostatic agent, but more information concerning its dosage, efficacy, and safety is required.
CASE: A primigravida developed preeclampsia complicated by disseminated intravascular coagulation and severe puerperal hemorrhage after an emergency cesarean at 35(+5) weeks of gestation. Two doses of recombinant factor VIIa controlled the hemorrhage without any thrombotic complications.
CONCLUSION: Recombinant factor VIIa should be considered when conventional methods fail to control puerperal hemorrhage complicated by disseminated intravascular coagulation. A review of 17 similar cases treated with this hemostatic agent revealed that in 76% a single dose ranging from 16.7 to 120 microg/kg controlled bleeding. Guidelines are needed to help obstetricians use recombinant factor VIIa effectively in such emergencies.
CASE: A primigravida developed preeclampsia complicated by disseminated intravascular coagulation and severe puerperal hemorrhage after an emergency cesarean at 35(+5) weeks of gestation. Two doses of recombinant factor VIIa controlled the hemorrhage without any thrombotic complications.
CONCLUSION: Recombinant factor VIIa should be considered when conventional methods fail to control puerperal hemorrhage complicated by disseminated intravascular coagulation. A review of 17 similar cases treated with this hemostatic agent revealed that in 76% a single dose ranging from 16.7 to 120 microg/kg controlled bleeding. Guidelines are needed to help obstetricians use recombinant factor VIIa effectively in such emergencies.