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Updated: Jul 19, 2026

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Factor VIIa in puerperal hemorrhage with disseminated intravascular coagulation
Litha P Pepas1, Merhnoosh Arif-Adib, Rezan A Kadir
1Department of Obstetrics and Gynecology, Royal Free Hospital, Hampstead, London, UK. lithapepas@hotmail.com
Background:
[corrected] Puerperal hemorrhage associated with disseminated intravascular coagulation is a life-threatening obstetric emergency. Recombinant factor VIIa is a novel hemostatic agent, but more information concerning its dosage, efficacy, and safety is required.
Case:
A primigravida developed preeclampsia complicated by disseminated intravascular coagulation and severe puerperal hemorrhage after an emergency cesarean at 35(+5) weeks of gestation. Two doses of recombinant factor VIIa controlled the hemorrhage without any thrombotic complications.
Conclusion:
Recombinant factor VIIa should be considered when conventional methods fail to control puerperal hemorrhage complicated by disseminated intravascular coagulation. A review of 17 similar cases treated with this hemostatic agent revealed that in 76% a single dose ranging from 16.7 to 120 microg/kg controlled bleeding. Guidelines are needed to help obstetricians use recombinant factor VIIa effectively in such emergencies.
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