Low-dose recombinant activated factor VII temporally stopped bleeding from small artery in severe postpartum hemorrhage: a case report.

Recombinant activated factor VII has been used to effectively treat uncontrolled massive hemorrhage at parturition in an off-label manner. Interventional radiology, including vessel embolization of the internal iliac artery or uterine artery for postpartum hemorrhage, is now familiar to obstetricians. However, this therapeutic technique is applicable only in patients who are hemodynamically stable. We encountered a case with severe and uncontrolled postpartum bleeding from the vaginal fornix. The patient received a low dose (<20 μg/kg) of factor VIIa and subsequently underwent vessel embolization. We herein report that this stepwise treatment was very effective for uncontrolled bleeding.