Bomken Charlotte, Mathai Sue, Biss Tina, Loughney Andrew, Hanley John
Department of Haematology, The Newcastle upon Tyne Hospitals NHS Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK.
Obstet Gynecol Int. 2009;2009:364843. doi: 10.1155/2009/364843. Epub 2010 Feb 3.
Major obstetric haemorrhage remains a significant cause of maternal morbidity and mortality. Previous case reports suggest the potential benefit of recombinant activated factor VII (rFVIIa: NovoSeven(R)) as a haemostatic agent. We performed a retrospective review of the use of rVIIa in major obstetric haemorrhage in the Northern Region between July 2004 and February 2007. Fifteen women received rFVIIa. The median patient age was 34 years. Major haemorrhage occurred antepartum (5 patients), intrapartum (1), and postpartum (9). All women received an initial dose of 90 mcg/kg rFVIIa and one received 2 further doses. Bleeding stopped or decreased in 12 patients (80%). Additional measures included antifibrinolytic and uterotonic agents, Rusch balloon insertion, uterine curettage/packing, and vessel embolisation. Eight patients required hysterectomy. All women survived to discharge from hospital. No adverse events, including thrombosis, were recorded. This study provides further support for the safety and efficacy of rFVIIa as adjunct therapy in major obstetric haemorrhage.
严重产科出血仍然是孕产妇发病和死亡的重要原因。先前的病例报告提示重组活化凝血因子VII（rFVIIa：诺其®）作为一种止血剂可能具有益处。我们对2004年7月至2007年2月间北部地区将rVIIa用于严重产科出血的情况进行了一项回顾性研究。15名妇女接受了rFVIIa治疗。患者的中位年龄为34岁。严重出血发生在产前（5例）、产时（1例）和产后（9例）。所有妇女均接受了90 mcg/kg的rFVIIa初始剂量，1名妇女又接受了2次额外剂量。12例患者（80%）出血停止或减少。其他措施包括抗纤溶和宫缩剂、Rusch球囊置入、刮宫/宫腔填塞及血管栓塞。8例患者需要行子宫切除术。所有妇女均存活至出院。未记录到包括血栓形成在内的不良事件。本研究为rFVIIa作为严重产科出血辅助治疗的安全性和有效性提供了进一步支持。
