title: 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.
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.
authors: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors: Jing-Yi
authors: JY
authors: Jan
authors: Shin-Yu
authors: SY
authors: Lin
authors: Chia-Hui
authors: CH
authors: Lin
authors: Chien-Nan
authors: CN
authors: Lee
authors: Shou-Zen
authors: SZ
authors: Fan
authors: Yin-Yi
authors: YY
authors: Han
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D004351:Drug Resistance; D015942:Factor VIIa / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D056687:Off-Label Use; D006473:Postpartum Hemorrhage / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D016879:Salvage Therapy; D013624:Taiwan; D013997:Time Factors; D055815:Young Adult
chemical_list: D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa