Information de reference pour ce titreAccession Number: | 00007536-200834010-00011.
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Author: | Franchini, Massimo M.D. 1; Franchi, Massimo M.D. 2; Bergamini, Valentino M.D. 2; Salvagno, Gian Luca M.D. 3; Montagnana, Martina M.D. 3; Lippi, Giuseppe M.D. 3
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Institution: | (1)Servizio di Immunoematologia e Trasfusione-Centro Emofilia, Azienda Ospedaliera di Verona, Verona; Italy; (2)Dipartimento Materno Infantile e di Biologia-Genetica, Sezione di Ginecologia e Ostetricia, Universita di Verona, Verona; Italy; (3)Istituto di Chimica eMicroscopia Clinica, Dipartimento di Scienze Biomediche e Morfologiche, Universita di Verona, Verona; Italy.
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Title: | |
Source: | Seminars in Thrombosis & Hemostasis. Hot Topics II: An Editorial Collection of Current Issues and Controversies in Thrombosis and Hemostasis. 34(1):104-112, February 2008.
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Abstract: | The objective of this review was to evaluate and summarize the current literature on the unlicensed use of the novel agent recombinant activated factor VII (rFVIIa) in the management of major postpartum hemorrhage. After a systematic electronic search without temporal limits on MEDLINE, EMBASE, OVID and SCOPUS, the bibliographic references of all retrieved studies and reviews were additionally assessed for further reports of clinical trials. Unpublished works were also identified by searching abstracts from the most eminent conferences on this topic. In total, there were 31 studies that fulfilled our inclusion criteria. These studies incorporated 118 cases of massive postpartum hemorrhage treated with rFVIIa. The median age of the patients was 31.4 years, and cesarean section appeared to increase the risk of postpartum hemorrhage. At a median dose of 71.6 &b.mu;g/kg, rFVIIa was reported to be effective in stopping or reducing bleeding in nearly 90% of the reported cases. Based on the evidence from the literature, we give some recommendations on the use of rFVIIa in massive postpartum hemorrhage. Nevertheless, although these reports suggest the potential role of rFVIIa in treating massive postpartum hemorrhage refractory to standard therapy, we advise particular caution in interpreting these results, as they are derived from few and uncontrolled studies. Further evidence is needed using well-designed clinical trials to better assess the optimal dose, the effectiveness, and the safety of rFVIIa in such critical bleeding conditions.
Copyright (C) 2008 by Thieme
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Author Keywords: | Postpartum hemorrhage; obstetrics; gynecology; bleeding; rFVIIa.
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Language: | English.
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Document Type: | Original Article.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0094-6176
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NLM Journal Code: | uks, 0431155
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