EXPERIENCE IN THE USE OF RECOMBINANT ACTIVATED COAGULATION FACTOR VII IN THE TREATMENT OF MASSIVE OBSTETRIC BLEEDING AND THE PLACENTA PREVIA AND ACCRETA

Abstract

The article presents a clinical observation of treatment of massive obstetric bleeding in pregnant (gestational age 35 weeks) with placenta and accreta using recombinant activated factor VII coagulation – Coagil-VII (Russia, “Generium”). In operation: laparotomy, caesarean section in the lower uterine segment transverse incision, ligation of the internal iliac arteries, metroplasty, tubal ligation for Genter, coagulopathic massive bleeding developed. Transfusion of FFP, autoerythrocytes, infusion of tranexam, crystalloid and colloid solutions were made. For the haemostatic effect rFVIIa Coagil-VII was introduced at a dose of 4.8 mg (70 mkg/kg) intravenous bolus. Within 15 minutes after bolus administration of the rFVIIa observed rapid and marked reduction in the rate of bleeding and volume in the operative field. This prevented the removal of the uterus and finish the metroplasty operation in favorable conditions. The analysis of the clinical observation indicates a high hemostatic effect of the Coagil-VII in treatment of the coagulopathic massive bleeding in pregnant women with placenta previa and accreta.

Keywords

• pregnancy
• placenta previa and accreta
• massive coagulopathic bleeding
• coagil
• metroplastyc