Successful Treatment of Severe Post-partum Bleeding after Caesarean
Section Using Recombinant Activated Factor VII
Holub Z.1, Feyereisl J.2, Kabelík L.3, Rittstein T.1
1Gynekologicko-porodnické oddělení, Nemocnice Kladno, primář doc. MUDr. Z. Holub, CSc. 2Gynekologicko-porodnická klinika, Ústav pro péči o matku a dítě, Praha, ředitel doc. MUDr. J. Feyereisl, CSc. 3Anesteziologicko-resuscitační oddělení, Nemocnice Kladno, primář MUDr. K. Kodras |
|
Summary:
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
|
