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Recombinant factor VIIa (rFVIIa) is effective at massive bleeding after caesarean section--a case report
V Sokolić1, D Buković, R Fures
1Department of Anesthesiology and Intensive Care Medicine, General Hospital Zabok, Zabok, Croatia.
Collegium Antropologicum
|April 5, 2003
Summary
A woman with HELLP syndrome required an emergency C-section. Postpartum hemorrhage and disseminated intravascular coagulation were successfully treated with recombinant factor VIIa, stabilizing the patient.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Critical Care Medicine
Background:
- HELLP syndrome, a severe form of preeclampsia, presents diagnostic challenges.
- Arterial hypertension, elevated liver enzymes, and proteinuria indicated HELLP syndrome in a 38-week gestation patient.
- Fetal distress necessitated an emergency cesarean section.
Observation:
- Massive uterine bleeding and hemorrhagic shock occurred postpartum despite initial replacement therapy.
- Disseminated intravascular coagulation (DIC) was diagnosed due to worsening laboratory parameters.
- Ultrasound revealed pathological flow in the umbilical artery and fetal aorta.
Findings:
- The patient presented with a HELLP score of 12, confirming the diagnosis.
- Recombinant factor VIIa administration rapidly decreased uterine bleeding.
- Laboratory data normalized following treatment with recombinant factor VIIa.
Implications:
- Recombinant factor VIIa is a potential life-saving treatment for severe postpartum hemorrhage associated with HELLP syndrome and DIC.
- Early recognition and management of HELLP syndrome are crucial for maternal and fetal outcomes.
- This case highlights the effectiveness of targeted therapy in critical obstetric emergencies.