Document Detail


The use of recombinant activated FVII in postpartum hemorrhage.
MedLine Citation:
PMID:  20142658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe bleeding remains a leading cause of morbidity and mortality in obstetrics. The first-line standard treatment of massive postpartum hemorrhage (PPH) includes medical measures directed at improving uterine tone, replacement of lost intravascular volume, blood and coagulation factors, and surgical or invasive procedures. Recently, a number of case reports or case series have reported the successful "off-label" use of recombinant activated factor VII (rFVIIa) in PPH unresponsive to conventional treatments. In this review, a critical analysis of the published literature on the use of rFVIIa in severe PPH was performed. Overall, a total of 272 PPH women were collected among the largest case series and/or international registries. No randomized controlled trials have been conducted in this area. Currently, the literature data suggest that, at a median dose of 81.5 microg/kg, rFVIIa is effective in stopping or reducing bleeding in 85% of the cases. Finally, on the basis of the evidence from the literature and on own experience, we included some recommendations and an algorithm on the therapeutic role of rFVIIa in the management of PPH.
Authors:
Massimo Franchini; Massimo Franchi; Valentino Bergamini; Martina Montagnana; Gian Luca Salvagno; Giovanni Targher; Giuseppe Lippi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical obstetrics and gynecology     Volume:  53     ISSN:  1532-5520     ISO Abbreviation:  Clin Obstet Gynecol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0070014     Medline TA:  Clin Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-27     Citation Subset:  IM    
Affiliation:
Department of Pathology and Laboratory Medicine, University Hospital of Parma, Immunohematology and Transfusion Center, Parma, Italy. mfranchini@ao.pr.it
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Factor VIIa / administration & dosage,  therapeutic use*
Female
Hemostatics / administration & dosage,  therapeutic use*
Humans
Off-Label Use
Postpartum Hemorrhage / drug therapy*
Pregnancy
Recombinant Proteins / administration & dosage,  therapeutic use
Chemical
Reg. No./Substance:
0/Hemostatics; 0/Recombinant Proteins; 0/recombinant FVIIa; EC 3.4.21.21/Factor VIIa

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


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