Document Detail


The role of recombinant activated factor VII in obstetric hemorrhage.
MedLine Citation:
PMID:  22473215     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: To review the literature regarding the use of recombinant activated factor FVII (rFVIIa) in the treatment of postpartum hemorrhage (PPH). RECENT FINDINGS: The previous and recent case reports and case series suggest a potential benefit of rFVIIa in the management of severe PPH refractory to standard treatment. However, the lack of randomized controlled studies limits the value of the available data. rFVIIa cannot work optimally if there is a shortage of the basic components of the coagulation cascade such as fibrinogen. New experimental data suggest that rFVIIa can relocate into the extravascular space and remain functionally active which may prolong its hemostatic effect longer than the short circulatory half-life indicates. SUMMARY: Although some preliminary guidelines have been published, the case reports and case series illustrate that the practice of using rFVIIa in PPH is far from uniform. Recombinant FVIIa should usually not be used to compensate for an inadequate transfusion therapy. Therefore, early and effective administration of red blood cells, fresh frozen plasma, fibrinogen concentrate (or cryoprecipitate), and platelets as well as the control of uterine atony are essential before considering administration of rFVIIa in the treatment of PPH.
Authors:
Jouni Ahonen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-2
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  -     ISSN:  1473-6500     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesia, Women's Clinic, Helsinki University Hospital, Helsinki, Finland.
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