Successful management by recombinant activated factor VII in a case of disseminated intravascular coagulopathy caused by obstetric hemorrhage.
Postpartum hemorrhage (PPH) is a life-threatening emergency in obstetrics. Although recombinant activated factor VII (rFVIIa) has become used for the treatment of some cases of massive hemorrhage, its applications in the field of obstetrics are still limited. We describe a case of successful treatment with rFVIIa for PPH due to placenta accreta. The patient was a 33-year-old woman with placental previa. Cesarean section (CS) was performed at gestational week 35. During CS, there was massive hemorrhage due to placenta accreta. After CS, disseminated intravascular coagulopathy and hypovolemic shock were diagnosed. The PPH was not controlled by transfusion therapy. On the fourth day after CS, rFVIIa (90 microg/kg x 2) was given because of the persistent PPH. Bleeding decreased and no further transfusion was required from 2 days after administration. rFVIIa was useful in the treatment of this case of obstetric hemorrhage.
Nohira
Tomoyoshi
T
Department of Obstetrics and Gynecology, Hachioji Medical Center of Tokyo Medical University, Tokyo, Japan. tnohira@mac.com
Osakabe
Yumi
Y
Suda
Shingo
S
Takahashi
Chie
C
Tanaka
Asashi
A
Ikeda
Kazumi
K
Ikeda
Toshiaki
T
Okabe
Kazuhiro
K
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy* / Q000209:etiology; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D010921:Placenta Accreta / Q000175:diagnosis; D006473:Postpartum Hemorrhage / Q000188:drug therapy*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa