Document Detail


Recombinant factor VIIa in the management of postpartum bleeds: an audit of clinical use.
MedLine Citation:
PMID:  17068684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This paper presents an analysis of 25 patient cases in which recombinant factor VIIa was used in the management of postpartum hemorrhage, including severe and/or life-threatening bleeds. Anecdotal experiences in the empirical use of this agent are described and dosing regimens, effects on bleeding, and safety data are presented. METHODS: Data were extracted from the international, internet-based, voluntary registry, haemostasis.com. Search results were manually cross-checked against monthly summary reports and cases of confirmed postpartum hemorrhage were analyzed by the authors. Case providers were contacted individually to approve the use of their cases, supply any missing data, and validate the data already held. RESULTS: Of 43 reported gynecological admissions for hemorrhage, 13 were excluded as they did not relate to childbirth, and 5 due to insufficient data. The remaining 25 records, all associated with postpartum hemorrhage, were submitted by 14 doctors from 5 countries. Following administration of recombinant factor VIIa, bleeding stopped in 18 cases (72%), markedly decreased in 2 (8%), and decreased in 4 (16%). Bleeding increased following recombinant factor VIIa administration in only 1 patient (4%). Requirements for replacement blood products and crystalloids/colloids were also greatly curtailed. A full recovery was achieved by most patients (22/25, 88%) with few complications, even when recombinant factor VIIa was administered as salvage therapy. There were no thrombotic complications associated with recombinant factor VIIa administration. CONCLUSIONS: This review provides the largest aggregate of cases in which recombinant factor VIIa has been used to control obstetrical bleeding. A review of these cases suggests that this agent may be a useful and safe adjunctive therapy in the management of postpartum hemorrhage.
Authors:
Slawomir Sobieszczyk; Grzegorz H Breborowicz; Viliyan Platicanov; Stoyan Tanchev; Craig M Kessler
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  85     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2006  
Date Detail:
Created Date:  2006-10-27     Completed Date:  2006-11-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1239-47     Citation Subset:  IM    
Affiliation:
Division of Hematology-Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Drug Administration Schedule
Drug Utilization Review*
Europe
Factor VIIa / administration & dosage,  therapeutic use*
Female
Hemostatic Techniques / utilization
Hemostatics / therapeutic use*
Humans
Medical Audit*
Outcome Assessment (Health Care)*
Postpartum Hemorrhage / drug therapy*,  pathology
Pregnancy
Recombinant Proteins / therapeutic use*
Registries
Chemical
Reg. No./Substance:
0/Hemostatics; 0/Recombinant Proteins; EC 3.4.21.21/Factor VIIa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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