title: Recombinant activated factor VII in the management of acute fatty liver of pregnancy: A case report.
abstract: A 20-year-old woman, primigravida at 36(+4) weeks' gestation presented with malaise, vomiting for 1 week, yellowish discoloration of the eyes for 3 days and loss of fetal movements. A clinical diagnosis of acute fatty liver with intrauterine fetal demise was made. Labor was induced with prostaglandin E2 gel and delivered vaginally. The post-partum period was complicated by atonic post-partum hemorrhage, an episode of seizure, recurrent hypoglycemic attack, hypokalemia and continuing coagulopathy. Supportive management in the intensive care unit using blood and blood products and injection recombinant activated factor VIIa to arrest the bleeding resulted in a successful outcome.
authors: Department of OBG, Manipal University, Mangalore, Karnataka, India.
authors: Supriya
authors: S
authors: K
authors: Department of OBG, Manipal University, Mangalore, Karnataka, India.
authors: Suchitra
authors: S
authors: Thunga
authors: Department of OBG, Manipal University, Mangalore, Karnataka, India.
authors: Athira
authors: A
authors: Narayanan
authors: Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Prakhar
authors: P
authors: Singh
mesh_terms: D000032:Abortion, Therapeutic; D000328:Adult; D003131:Combined Modality Therapy; D015942:Factor VIIa / Q000627:therapeutic use*; D005234:Fatty Liver / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007565:Jaundice / Q000209:etiology; D008099:Liver / Q000000981:diagnostic imaging; D066087:Perinatal Death / Q000209:etiology*; D006473:Postpartum Hemorrhage / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: acute fatty liver of pregnancy; coagulopathy in pregnancy; jaundice in pregnancy; recombinant activated factor VII