Successful Treatment of Severe Post-partum Bleeding after Caesarean Section Using Recombinant Activated Factor VII

Czech version

Authors: Holub Z. ¹; Feyereisl J. ²; Kabelík L. ³; Rittstein T. ¹
Authors‘ workplace: Gynekologicko-porodnické oddělení, Nemocnice Kladno, primář doc. MUDr. Z. Holub, CSc. ¹; Gynekologicko-porodnická klinika, Ústav pro péči o matku a dítě, Praha, ředitel doc. MUDr. J. Feyereisl, CSc. ²; Anesteziologicko-resuscitační oddělení, Nemocnice Kladno, primář MUDr. K. Kodras ³
Published in: Ceska Gynekol 2005; 70(2): 144-148
Category: Original Article

Prezentace kazuistiky těžkého poporodního krvácení po císařském řezu a úspěšného použití rekombinantního faktoru VII.

Overview

Objective:
To present a case report of severe post-partum bleeding after caesarean section and successful using recombinant factor VIIa.

Setting:
Department Obstetrics and Gynecology, Regional Hospital, Kladno, Czech Republic.

Case Report:
A 28-year old nullipara presented with major post-partum bleeding after caesarean section due to uterine atony. The patient developed hemorrhagic shock, associated with disseminated intravascular coagulation (DIC). Treatment with uterotonics drug, prostaglandins, hysterectomy and packing of the pelvis failed to control diffuse pelvic and vaginal bleeding. Recombinant factor VIIa (2.4 mg intravenous injection) was given as a final attempt to control the bleeding before relaparotomy and ligation hypogastric artery. The response to treatment was rapid, with control of the bleeding and resolution of the coagulopathy.

Conclusion:
This case suggests a potential role of recombination factor VIIa in the treatment of severe post-partum bleeding associated with DIC.

Key words:
recombinant activated factor VII, disseminated intravascular coagulation, post-partum bleeding