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  • Title: Factor VIIa in puerperal hemorrhage with disseminated intravascular coagulation.
    Author: Pepas LP, Arif-Adib M, Kadir RA.
    Journal: Obstet Gynecol; 2006 Sep; 108(3 Pt 2):757-61. PubMed ID: 17018493.
    Abstract:
    BACKGROUND: [corrected] Puerperal hemorrhage associated with disseminated intravascular coagulation is a life-threatening obstetric emergency. Recombinant factor VIIa is a novel hemostatic agent, but more information concerning its dosage, efficacy, and safety is required. CASE: A primigravida developed preeclampsia complicated by disseminated intravascular coagulation and severe puerperal hemorrhage after an emergency cesarean at 35(+5) weeks of gestation. Two doses of recombinant factor VIIa controlled the hemorrhage without any thrombotic complications. CONCLUSION: Recombinant factor VIIa should be considered when conventional methods fail to control puerperal hemorrhage complicated by disseminated intravascular coagulation. A review of 17 similar cases treated with this hemostatic agent revealed that in 76% a single dose ranging from 16.7 to 120 microg/kg controlled bleeding. Guidelines are needed to help obstetricians use recombinant factor VIIa effectively in such emergencies.
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