Recombinant factor VIIa to successfully manage disseminated intravascular coagulation from amniotic fluid embolism.
BACKGROUND
Amniotic fluid embolism (AFE) is a rare syndrome that can complicate pregnancy and labor. It often has debilitating and lethal consequences. One serious sequela of AFE is disseminated intravascular coagulation (DIC).


METHODS
This report describes an atypical presentation of AFE manifested by sudden fetal bradycardia and complicated by maternal DIC. The DIC was eventually successfully treated with the use of recombinant activated factor VIIa.


CONCLUSIONS
The use of recombinant activated factor VIIa in cases of massive hemorrhage, such as in our patient, is controversial but has been shown, in some cases, to reverse DIC and be successful. The use of recombinant activated factor VIIa should be considered in patients with massive obstetric hemorrhage in whom standard measures of stabilization are unsuccessful.
Prosper
Soumathy C
SC
Department of Maternal Fetal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA.
Goudge
Christine S
CS
Lupo
Virginia R
VR
D000328:Adult; D002585:Cesarean Section; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D004619:Embolism, Amniotic Fluid; D015942:Factor VIIa / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis
D015942:Factor VIIa