Role of Recombinant activated FVII in severe Post‐Partum Haemorrhage
In Pakistan, improvement of the health care system and advancement in perinatal management have led to a significant reduction in maternal mortality, however obstetrical haemorrhage has still remained the leading cause of maternal motility. The aim of this study was to investigate the utilization of recombinant activated Factor VII (rFVIIa) for severe post‐partum haemorrhage (PPH). This study was conducted in the Department of Obstetrics and Gynaecology, National Hospital and Medical Centre DHA, Lahore and Hameed Latif Hospital, Lahore. Duration of study was 9 months from 01/01/2020 to 30/09/2020. This study included 15 patients with severe PPH were treated with rFVIIa. Overall, the mean and median blood loss were 11835 mL and 8639 mL, respectively. Treatment before rFVIIa included trans-arterial embolization in 05 patients and hysterectomy in 03. One patient had a single dose, two had two doses, three had four doses, two had five plus doses and only one had twenty plus doses of rFVIIa. The mean (± SD) single dose was 81.60 ± 16.25 µg/kg. Fourteen patients survived, and one died because of complication. The cause death was uterine rupture and the amount of blood loss in cases of death was 6428–43 810 mL. This might be concluded that whether a patient survives or not was more dependent on her general condition before and after rFVIIa infusion than on the amount of blood loss. Four patients had thromboembolic events after rFVIIa treatment (deep vein thrombosis; deep vein thrombosis plus pulmonary embolism; acute myocardial infarction; and pulmonary embolism). This study showed that rFVIIa infusion had promising effects for severe PPH and markedly reduced the maternal motility.
Key Words: Post-Partum Haemorrhage, Hystectomy, rFVIIa, thromboembolism
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