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Federación Mexicana de Ginecología y Obstetricia, A.C.

2018, Number 12

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Ginecol Obstet Mex 2018; 86 (12)

Use of recombinant activated Factor VII in severe obstetric hemorrhage

Corona-Gutiérrez AA, García-Ruan K, Camarena-Pulido EE, López-Aceves LJ, González-Moreno J, Fajardo-Dueñas S

Language: Spanish
References: 17
Page: 779-786
PDF size: 234.65 Kb.


ABSTRACT

Objective: To describe outcome of patients with severe obstetric hemorrhage (≥ 1000 mL) treated with rFVIIa as part of the management and to detect complications related to its use.
Materials and Methods: Retrospective, cross-sectional and descriptive study carried out in patients with severe obstetric hemorrhage treated at the Hospital Civil de Guadalajara Dr. Juan I Menchaca between 2001 and 2017 and treated with activated recombinant factor VII. We identified relevant antecedents, average dose and number of doses of rFVIIa, and hemostatic response. We determined if quantity of bleeding, administration of blood products and hematological parameters before and after using rFVIIa was significantly different.
Results: We identified ten patients with rFVIIa administration. The cause of severe obstetric hemorrhage was uterine atony in six cases. The average dose of rFVIIa was 91 mcg/kg; one dose was administered in eight patients and two doses in two patients. Hemostasis was achieved in all patients, bleeding decreased significantly after ad- ministration of rFVIIa (5075 mL vs 928 mL, p = 0.000) and the number of erythrocyte concentrates required (7 vs 3, p = 0.006). One patient did not require a hysterectomy after rFVIIa administration; one patient presented pulmonary thromboembolism and recovered without complications, no patient died.
Conclusion: rFVIIa administration as a hemostatic in severe obstetric hemorrhage had favorable results, preventing hysterectomy in one patient. Follow-up requires close monitoring of thrombosis.


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