title: Efficacy of recombinant human soluble thrombomodulin in severe postpartum hemorrhage with disseminated intravascular coagulation.
abstract: OBJECTIVE
  To investigate the efficacy of recombinant human soluble thrombomodulin (rTM) in disseminated intravascular coagulation (DIC) associated with severe postpartum hemorrhage (PPH).
  
  
  METHODS
  We conducted a retrospective review of 36 patients with severe PPH complicated by DIC admitted to a single tertiary center. The first 26 patients were treated without rTM (control group), and the next 10 consecutive patients were treated with rTM. Clinical parameters including bleeding symptoms and coagulation indices were evaluated.
  
  
  RESULTS
  Baseline characteristics, total blood loss, and transfusion requirements were similar between the 2 groups. On day 2, there was a significant difference between the 2 groups in the decrease in d-dimer level from baseline. The incidence of bleeding symptoms was decreased in the rTM group compared with the control group. No adverse events were observed in the rTM group.
  
  
  CONCLUSIONS
  Recombinant human thrombomodulin may be an effective adjunctive therapy in the management of DIC related to PPH.
authors.affiliation: 1Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Sugawara
authors.forename: Kaori
authors.initials: K
authors.lastname: Suenaga
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Hoshiai
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nishigori
authors.forename: Satoru
authors.initials: S
authors.lastname: Nagase
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
mesh_terms: D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000097:blood / Q000188:drug therapy*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D018180:Thrombomodulin / Q000627:therapeutic use*
chemical_list: D011994:Recombinant Proteins; C546931:THBD protein, human; D018180:Thrombomodulin