Korean J Perinatol.  2013 Mar;24(1):29-36. 10.14734/kjp.2013.24.1.29.

Clinical Efficacy of Recombinant Activated Factor VII in Management of Postpartum Hemorrhage

• Moon SH
• Kim SC
• Joo JK
• Suh DS
• Lee DH

• KMID: 1427072
• DOI: http://doi.org/10.14734/kjp.2013.24.1.29

Abstract

PURPOSE
This study was aimed to investigate the clinical efficacy of recombinant activated factor VII (rFVIIa) for patients with intractable postpartum hemorrhage.
METHODS
This was a retrospective study of ten patients who were treated with rFVIIa from July 2010 to February 2012 in one tertiary center. To evaluate each case, we used a standardized case record form. The primary outcome measures were response of rFVIIa, reduction of blood product requirement, changes of coagulation parameter. The response of rFVIIa was categorized to three groups: "complete responder", "partial responder", "poor responder".
RESULTS
After the administration of rFVIIa, effect for bleeding was completely responded in 4 patients, partially responded in 6 patients, and poorly responded in none. A certain amount of reduction in blood product requirements was noted following rFVIIa administration, although no significant differences were observed statistically between before and after rFVIIa administration except RBC (P<0.01). Fibrinogen and INR were significantly reduced in all case types, but other coagulation parameters were not (P<0.01).
CONCLUSION
The present results suggest that rFVIIa is a beneficial therapeutic option that could reduce blood loss and contribute to reduction of maternal morbidities and mortalities in patients with massive postpartum hemorrhage.

Keyword

Clinical efficacy; Postpartum hemorrhage; Recombinant activated factor VII

MeSH Terms

Factor VIIa
Fibrinogen
Hemorrhage
Humans
International Normalized Ratio
Outcome Assessment (Health Care)
Postpartum Hemorrhage
Postpartum Period
Recombinant Proteins
Retrospective Studies
Factor VIIa
Fibrinogen
Recombinant Proteins

Figure

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  Fig. 1 Comparison of requirement of RBC, FFP and PLT concentrates before (A) and after (B) administration of rFVIIa.

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  Fig. 2 Comparison of aPTT, fibrinogen, INR and platelets level before (A) and after (B) administration of rFVIIa.

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