Successful treatment of severe intra-abdominal bleeding associated with disseminated intravascular coagulation using recombinant activated factor VII.
Recombinant activated factor VII (rFVIIa) is indicated mainly for the treatment of patients with haemophilia and inhibitors. However, little information is available on the use of rFVIIa in the treatment of the severe bleeding associated with disseminated intravascular coagulation (DIC). We report a pregnant woman with DIC, who developed severe intra-abdominal bleeding after caesarean section. Despite treatment with fresh-frozen plasma, fibrinogen, platelet transfusions and surgery, the abdominal bleeding persisted and intravenous treatment with rFVIIa was initiated. The response to treatment was rapid, with control of the bleeding and resolution of the coagulopathy. No side-effects related to rFVIIa were noted. This case suggests a potential role for rFVIIa in the treatment of severe and refractory bleeding associated with DIC.
Moscardó
F
F
Department of Haematology, Hospital Universitario La Fe, Valencia, Spain.
Pérez
F
F
de la Rubia
J
J
Balerdi
B
B
Lorenzo
J I
JI
Senent
M L
ML
Aznar
I
I
Carceller
S
S
Sanz
M A
MA
D000208:Acute Disease; D000328:Adult; D002585:Cesarean Section; D003131:Combined Modality Therapy; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy*; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use; D006801:Humans; D010949:Plasma; D017713:Platelet Transfusion; D019106:Postoperative Hemorrhage / Q000188:drug therapy*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012086:Reoperation
D011994:Recombinant Proteins; D005340:Fibrinogen; D015942:Factor VIIa