Recombinant factor VIIa and other pro-haemostatic therapies in primary postpartum haemorrhage.
Blood products are an essential component of the management of postpartum haemorrhage, although there is lack of evidence to guide optimal use. Prospective intervention studies, including randomized trials, are needed to clarify optimal timing and dosage. The new generation of virally inactivated blood products, such as fibrinogen concentrate, might further enhance our knowledge of the value of individual blood components. It seems likely that antifibrinolytic agents will receive less attention in future. However, rFVIIa promises to be a powerful tool in managing massive obstetric haemorrhage, although many questions concerning its efficacy and safety in differing clinical scenarios remain unanswered.
University Hospitals of Leicester, Leicester, UK.
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Searle
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Pavord
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Alfirevic
D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000379:methods; D002985:Clinical Protocols; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006487:Hemostasis / Q000187:drug effects*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D006473:Postpartum Hemorrhage / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use
D000933:Antifibrinolytic Agents; D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa