[Post-partum hemorrhage: new therapeutic options].

Bleeding remains a major cause of morbidity and mortality in obstetrics. Recombinant activated factor VII (rFVIIa), which was originally developed for the treatment of bleeding in hemophilic patients with inhibitors, has been recently employed to prevent or control bleeding in several other non-hemophilic bleeding conditions. Among the newer, "off-label" clinical applications of rFVIIa, its use in the treatment of obstetrical bleeding unresponsive to conventional therapy has generated intense interest. The existing literature on the use of rFVIIa in post-partum hemorrhage (PPH) is analysed in this review. Although supported by few and uncontrolled studies, on the whole the published data suggest a potential role of rFVIIa in the management of PPH. However, further evidences are needed in order to better assess the optimal dose, the effectiveness and the safety of rFVI-Ia in such critical bleeding conditions.