Recombinant Activated Factor VII as a Second Line Treatment for Postpartum Hemorrhage

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Critical Care Medicine

Background:

• Postpartum hemorrhage (PPH) is a major global cause of maternal mortality.
• Severe PPH often leads to critical obstetric complications.
• Recombinant activated factor VII (rFVIIa) is an off-label adjunctive hemostatic agent for life-threatening PPH refractory to conventional therapies.

Purpose of the Study:

• To evaluate the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, and severity change in Korean patients with severe PPH.
• To assess the impact of rFVIIa on Sequential Organ Failure Assessment (SOFA) scores in severe PPH patients.

Main Methods:

• Retrospective review of medical records for severe PPH patients treated with rFVIIa between December 2008 and March 2011.
• Comparison of demographic data, rFVIIa treatment, transfusion volume, and SOFA scores (initial and 24 hours post-treatment) for patients with initial SOFA scores ≥ 8.
• Analysis of changes in SOFA scores between initial presentation and 24 hours post-treatment.

Main Results:

• Fifteen women with SOFA score ≥ 8 were included; 8 received rFVIIa, and 7 did not.
• No statistically significant difference in initial or 24-hour SOFA scores between the rFVIIa and non-rFVIIa groups.
• A significant reduction in the change of SOFA score from initial presentation to 24 hours was observed in patients who received rFVIIa (P = 0.016).

Conclusions:

• Administration of rFVIIa can reduce the severity of life-threatening PPH.
• Rapid decision-making for rFVIIa administration is crucial for favorable outcomes in severe PPH patients lacking effective standard treatments.