title: Preliminary experience with use of recombinant activated factor VII to control postpartum hemorrhage in acute fatty liver of pregnancy and other pregnancy-related liver disorders.
abstract: Control of postpartum hemorrhage is difficult in patients with coagulopathy due to acute liver failure. Recombinant activated factor VII (rFVIIa) can help in control of bleed; however, it has short duration of action (2-4 h). The study aimed to report the use of rFVIIa in this setting. We retrospectively analyzed all patients with acute liver failure secondary to pregnancy-related liver disorders who received rFVIIa for control of postpartum hemorrhage (six patients, all six met diagnostic criteria for acute fatty liver of pregnancy). One dose of rFVIIa achieved adequate control of bleeding in five patients, while one patient needed a second dose. rFVIIa administration corrected coagulopathy and significantly reduced requirement of packed red cells and other blood products. No patient had thrombotic complications. In conclusion, rFVIIa was a useful adjunct to standard management in postpartum hemorrhage secondary to acute liver failure of pregnancy-related liver disorders.
authors.affiliation: Department of Hepatology, Christian Medical College, Vellore 632 004, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Goel
authors.forename: Sukesh Chandran
authors.initials: SC
authors.lastname: Nair
authors.forename: Auro
authors.initials: A
authors.lastname: Viswabandya
authors.forename: Vinodh P
authors.initials: VP
authors.lastname: Masilamani
authors.forename: Shoma V
authors.initials: SV
authors.lastname: Rao
authors.forename: Alice
authors.initials: A
authors.lastname: George
authors.forename: Annie
authors.initials: A
authors.lastname: Regi
authors.forename: Ruby
authors.initials: R
authors.lastname: Jose
authors.forename: Uday
authors.initials: U
authors.lastname: Zachariah
authors.forename: Kandasamy
authors.initials: K
authors.lastname: Subramani
authors.forename: C E
authors.initials: CE
authors.lastname: Eapen
authors.forename: George
authors.initials: G
authors.lastname: Chandy
mesh_terms: D000328:Adult; D001778:Blood Coagulation Disorders / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D015942:Factor VIIa / Q000008:administration & dosage*; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa