Prophylactic treatment of hereditary severe factor VII deficiency in pregnancy.
: Severe hereditary factor VII deficiency is a rare bleeding disorder and may be associated with a severe bleeding phenotype. We describe a pregnancy in a 33-year-old woman with compound heterozygous factor VII deficiency and a history of severe menorrhagia and mucocutaneous bleedings. After discontinuation of contraceptives, menstruation was covered with recombinant activated factor VII (rFVIIa), and during pregnancy, rFVIIa had to be administered in first trimester in doses ranging from 15 to 90 μg/kg per day because of recurrent retroplacental hematomas and vaginal bleedings. Thrombin generation was measured in first trimester at different doses of rFVIIa and showed an increase in lag time when doses of less than 30 μg/kg/day were administered, whereas time to thrombin peak and peak thrombin were not influenced. A low-dose rFVIIa prophylactic treatment of 15 μg/kg every other day in the late second and in the third trimester was sufficient to allow a successful childbirth in this patient with severe factor VII deficiency.
aDepartment of Hematology and Medical Oncology, University Hospital Leipzig bMVZ Labor Dr Reising-Ackermann und Kollegen, Center of Hemostasis, Leipzig cDepartment of Nursing and Health Sciences, Fulda University of Applied Sciences, Fulda, Germany.
Christian
C
Pfrepper
Annelie
A
Siegemund
Sven
S
Hildebrandt
Juliane
J
Kronberg
Ute
U
Scholz
Dietger
D
Niederwieser
D000328:Adult; D005168:Factor VII Deficiency / Q000628:therapy*; D015942:Factor VIIa / Q000008:administration & dosage; D005260:Female; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D011256:Pregnancy Outcome; D011292:Premedication / Q000379:methods; D011994:Recombinant Proteins / Q000008:administration & dosage
D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa