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The activated recombinant factor VII in the severe postpartum bleeding


Authors: MUDr. Jitka Mannová 1;  prim. MUDr. Martin Petrenko;  CSc. 2;  MUDr. Dagmar Seidlová 1;  MUDr. Helena Ondrášková 1;  MUDr. Martina Mokrá 1;  MUDr. Iveta Zimová 1
Authors place of work: 1. anesteziologicko-resuscitační oddělení FN Brno 1;  Gynekologicko-porodnická klinika LF MU a FN Brno 2
Published in the journal: Prakt Gyn 2006; 10(1): 6-10

Summary

The cases of severe ante partum and post partum haemorrhagia were presented in two patients, in the therapy of which all the options of available treatment were used, including the administration of activated recombinant factor VII. In the 1st patient, NovoSeven was indicated for the treatment of serious disseminated intravascular coagulation (DIC), there was sufficient 1 dose of activated recombinant factor VII - 90 mcg/kg, with consequent quick haemostasis, with the coagulation values arrangement and without necessity to proceed to hysterectomy. In the 2nd patient there were administered 2 doses of NovoSeven – 2 times 90 mcg/kg as the last therapeutic option of the treatment of post partum bleeding, but at the same time it was necessary to make supracervical uterine amputation, transient small pelvic and vaginal tamponade and the selective embolization of both internal iliac arteries to stop the bleeding.

Key words:
activated recombinant factor VII – obstetric bleeding – hemocoagulation disorder


Zdroje

1. Cetkovský P, Adam Z, Balík M et al. Intenzivní péče v hematologii. Praha: Galén 2004: 316-325.

2. Petrenko M. Embolie. In: Roztočil A et al. Porodnictví. Brno: IDVPZ 2001: 267-272.

3. Hedner U, Erhardtsen E. Potential role for rFVIIa in transfusion medicine. Transfusion 2002; 42: 114-124.

4. Kessler C. Antidotes to haemorrhage: recombinant factor VIIa. Best Pract Res Clin Haematol 2004; 17: 183-197.

5. Bouwmeester F, Jonkhoff A, Verheijen R, Geijn H. Succesful treatment of life threatening postpartum hemorrhage with recombinant acivated factor VII. Obstet Gynecol 2003 101(6): 1174-1176.

6. Price G, Kaplan J, Skowronski G. Use of recombinant factor VIIa to treat life-threatening non surgical bleeding in a post-partum patient. Br J Anaesth 2004; 93(2): 298-300.

7. Segal S, Shemesh IY, Blumenthal R et al. Treatment of obstetric hemorrhage with recombinant activated factor VII. Arch Gynecol Obstet 2003; 268(4): 266-267.

8. Bombeli T, Spahn DR. Updates in perioperative coagulation: physiology and management of tromboembolism and haemorrhage. Br J Anaesth 2004; 93(2): 275-287.

Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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