[Successful treatment of severe post-partum bleeding after caesarean section using recombinant activated factor VII].

Abstract

OBJECTIVE: To present a case report of severe post-partum bleeding after caesarean section and successful using recombinant factor VIIa. SETTING: Department Obstetrics and Gynecology, Regional Hospital, Kladno, Czech Republic. CASE REPORT: A 28-year old nullipara presented with major post-partum bleeding after caesarean section due to uterine atony. The patient developed hemorrhagic shock, associated with disseminated intravascular coagulation (DIC). Treatment with uterotonics drug, prostaglandins, hysterectomy and packing of the pelvis failed to control diffuse pelvic and vaginal bleeding. Recombinant factor VIIa (2.4 mg intravenous injection) was given as a final attempt to control the bleeding before relaparotomy and ligation hypogastric artery. The response to treatment was rapid, with control of the bleeding and resolution of the coagulopathy. CONCLUSION: This case suggests a potential role of recombination factor VIIa in the treatment of severe post-partum bleeding associated with DIC.