Recombinant activated factor VII as a promising adjuvant therapy for postpartum hemorrhage in the practice of obstetric anesthesia: Experience from a university hospital in Taiwan
Journal
Journal of Obstetrics and Gynaecology Research
Journal Volume
37
Journal Issue
7
Pages
901-907
Date Issued
2011
Author(s)
Abstract
Massive postpartum hemorrhage is one of the major complications in the peripartum period. In some critical cases, hemostasis is hard to achieve even after a hysterectomy has been performed. Recombinant activated factor VII has been reported as a promising adjuvant therapy for obstetric hemorrhage, although it remains unlicensed for this indication. Eight cases receiving recombinant activated factor VII in postpartum hemorrhage refractory to the conventional therapy in a Taiwanese hospital were analyzed retrospectively. A good response, defined as bleeding control in 15 min, was achieved in six patients (75%) with a single dose ranging from 55 to 105 μg/kg. The two patients with a poor response were later discovered to have had unsolved birth canal injuries. No drug-related adverse effects were noted. We recommend that any surgical bleeding should first be controlled, as well as the correction of metabolic and hematological abnormalities; however, in the situation of intractable postpartum hemorrhage, recombinant activated factor VII offers a salvage therapy and should be considered early, even before hysterectomy. ? 2011 The Authors.
SDGs
Other Subjects
fresh frozen plasma; methylergometrine; oxytocin; recombinant blood clotting factor 7a; absence of side effects; article; bleeding; chorioamnionitis; clinical article; disease control; disseminated intravascular clotting; drug indication; erythrocyte transfusion; female; human; hysterectomy; maternal morbidity; maternal mortality; medical practice; medical record review; obstetric anesthesia; placenta accreta; postoperative period; postpartum hemorrhage; repeated drug dose; retrospective study; salvage therapy; single drug dose; Taiwan; thrombocyte transfusion; treatment response; university hospital; uterine atony; vaginal delivery; Adult; Anesthesia, Obstetrical; Drug Resistance; Factor VIIa; Hemostatics; Hospitals, University; Humans; Male; Off-Label Use; Postpartum Hemorrhage; Recombinant Proteins; Retrospective Studies; Salvage Therapy; Taiwan; Time Factors; Young Adult
Type
journal article