Recombinant factor VIIa (rFVIIa) its effective at massive bleeding after caesarean section - A case report

A case of 31-year old woman who underwent emergency caesarean section (CS) following suspicion of the HELLP syndrome was reported. She developed arterial hypertension in 33(rd) week. In 38(th) week of her gestation elevated liver enzymes and positive albumin in urine were reported and pathological flow in umbilical artery and fetal aorta was found on ultrasound. The HELLP score was 12 and the HELLP syndrome was diagnosed. The pregnancy was terminated by CS for fetal distress and the HELLP syndrome. Two hours after the section she developed massive uterine bleeding with the signs of hemorrhagic shock. Despite of replacement therapy laboratory data worsened. DIC was diagnosed. Recombinant factor VIM was administrated; after several minutes bleeding decreased and laboratory data normalized.