Use of recombinant activated factor VII in severe post-partum haemorrhage: Data from the Italian Registry

Barillari, Giovanni; Frigo, Maria Grazia; Casarotto, Maddalena; Farnia, Antonio; Massè, Barbara; Wetzl, Roberto Giorgio; Bianchin, Andrea; Rabi, Andras; Malacarne, P; Pasca, Samantha; Bigotto, Enrico

doi:10.1016/j.thromres.2009.08.018

Cited by 24 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among the remaining 40 studies with usable information, we included only those reporting more than 10 cases in the final analysis. Thus, we considered 9 studies for this review, [14][15][16][17][18][19][20][21][22] with data on 272 PPH patients (the 31 excluded studies evaluated 57 patients). Figure 1 shows the flow chart of studies included in this chapter.…”

Section: Search Methodsmentioning

confidence: 99%

The Use of Recombinant Activated FVII in Postpartum Hemorrhage

Franchini¹,

Franchi

Bergamini

et al. 2010

Clinical Obstetrics &Amp; Gynecology

128

View full text Add to dashboard Cite

Severe bleeding remains a leading cause of morbidity and mortality in obstetrics. The first-line standard treatment of massive postpartum hemorrhage (PPH) includes medical measures directed at improving uterine tone, replacement of lost intravascular volume, blood and coagulation factors, and surgical or invasive procedures. Recently, a number of case reports or case series have reported the successful "off-label" use of recombinant activated factor VII (rFVIIa) in PPH unresponsive to conventional treatments. In this review, a critical analysis of the published literature on the use of rFVIIa in severe PPH was performed. Overall, a total of 272 PPH women were collected among the largest case series and/or international registries. No randomized controlled trials have been conducted in this area. Currently, the literature data suggest that, at a median dose of 81.5 microg/kg, rFVIIa is effective in stopping or reducing bleeding in 85% of the cases. Finally, on the basis of the evidence from the literature and on own experience, we included some recommendations and an algorithm on the therapeutic role of rFVIIa in the management of PPH.

show abstract

Section: Search Methodsmentioning

confidence: 99%

The Use of Recombinant Activated FVII in Postpartum Hemorrhage

Franchini¹,

Franchi

Bergamini

et al. 2010

Clinical Obstetrics &Amp; Gynecology

128

View full text Add to dashboard Cite

show abstract

“…3655. [19] In Italy, a single bolus of rFVIIa 60 μg/kg economically corresponds to cost of 14 PRBC.t[9] Ahonen and Jokela reported from Finland that at their institution, the cost of a single dose of rFVIIa is similar to that of transfusion with 50 units of red blood cells, an embolization procedure, or Intensive care unit treatment for 2 days. [8]…”

Section: Discussionmentioning

confidence: 99%

“…In last 10 years, there have been a number of case reports and series documenting successful treatment of PPH with rFVIIa. [7–9] We performed a MEDLINE search to review relevant articles in English literature on use of rFVIIa in PPH. Data were constructed and issues were reviewed.…”

Section: Introductionmentioning

confidence: 99%

Recombinant factor VIIa in post-partum hemorrhage: A new weapon in obstetrician′s armamentarium

Magon

Babu

2012

North Am J Med Sci

View full text Add to dashboard Cite

Post-partum hemorrhage (PPH) is a life-threatening obstetric complication and the leading cause of maternal death. The usual manner for its management includes, first, noninvasive and nonsurgical methods, and, then invasive and surgical methods. However, mortality and morbidity related to PPH still remains unacceptably high, contributing to hysterectomy in at least 50% of cases. Early, effective, and preferably noninvasive treatments that can reduce maternal mortality and morbidity due to this entity are therefore essential. One of the most spectacular advancements in the control of PPH has been the use of recombinant activated factor (rFVIIa), both as initial and a life- and uterus-saving therapy. rFVIIa also reduces costs of therapy and use of blood components in massive PPH. In cases of intractable bleeding with no other obvious indications for hysterectomy, administration of rFVIIa should be considered before surgery. A MEDLINE search was done to review relevant articles in English literature on use of rFVIIa in PPH. Data were constructed and issues were reviewed from there. Our experience in a series of three cases of PPH, two of atonic and one of traumatic, successfully managed using rFVIIa is also shared.

show abstract

“…However, from various studies conducted in western nations where laborious cost calculations are done, rFVIIa has been reported to reduce costs of therapy and use of blood components in massive PPH. In Italy, a single bolus of rFVIIa at 60 μg/kg equals to the cost of 14 PRBC 16. In UK, blood components worth £6255 are used in a single case, whereas rFVIIa cost for a patient in treatment is £3655 29.…”

Section: Overview Of Haemostasis and Role Of Rfviiamentioning

confidence: 99%

“…From the first reported usage of rFVIIa in obstetric haemorrhage almost a decade back,13 it has made an impressive journey and saved many human lives. In last decade, there have been a number of case reports and series documenting successful management of PPH using rFVIIa 141516. There are no randomized controlled trials conducted, and for reasons that hardly require amplification, it is highly implausible that they will ever be performed in patients with life-threatening PPH.…”

Section: Introductionmentioning

confidence: 99%

Recombinant activated factor VII in post partum haemorrhage

et al. 2013

View full text Add to dashboard Cite

Post-partum haemorrhage (PPH) is a life-threatening obstetric complication and the leading cause of maternal death. Any bleeding that results in or could result in haemodynamic instability, if untreated, must be considered as PPH. There is no controversy about the need for prevention and treatment of PPH. The keystone of management of PPH entails first, non-invasive and nonsurgical methods and then invasive and surgical methods. However, mortality remains high. Therefore, new advancements in the treatment are most crucial. One such advancement has been the use of recombinant activated factor VII (rFVIIa) in PPH. First used 12 years back in PPH, this universal haemostatic agent has been effectively used in controlling PPH. The best available indicator of rFVIIa efficacy is the arrest of haemorrhage, which is judged by visual evidence and haemodynamic stabilization. It also reduces costs of therapy and the use of blood components in massive PPH. In cases of intractable PPH with no other obvious indications for hysterectomy, administration of rFVIIa should be considered before surgery. We share our experience in a series of cases of PPH, successfully managed using rFVIIa.

show abstract

Use of recombinant activated factor VII in severe post-partum haemorrhage: Data from the Italian Registry

Cited by 24 publications

References 28 publications

The Use of Recombinant Activated FVII in Postpartum Hemorrhage

The Use of Recombinant Activated FVII in Postpartum Hemorrhage

Recombinant factor VIIa in post-partum hemorrhage: A new weapon in obstetrician′s armamentarium

Recombinant activated factor VII in post partum haemorrhage

Contact Info

Product

Resources

About