Franchini Massimo
Servizio di Immunoematologia e Trasfusione, Centro Emofilia, Azienda Ospedaliera, Verona.
Recenti Prog Med. 2007 Jan;98(1):7-11.
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.
出血仍然是产科发病和死亡的主要原因。重组活化因子VII（rFVIIa）最初是为治疗有抑制剂的血友病患者的出血而研发的，最近已被用于预防或控制其他几种非血友病性出血情况。在rFVIIa较新的“非适应证”临床应用中，其在治疗对传统疗法无反应的产科出血方面的应用引起了强烈关注。本综述分析了关于rFVIIa用于产后出血（PPH）的现有文献。尽管仅有少数无对照研究提供支持，但总体而言，已发表的数据表明rFVIIa在PPH管理中具有潜在作用。然而，需要进一步的证据来更好地评估rFVIIa在这种严重出血情况下的最佳剂量、有效性和安全性。
