Factor VIIa treatment of DIC as a clinical manifestation of amniotic fluid embolism in a patient with fetal demise

Arch Gynecol Obstet. 2009 Jul;280(1):127-9. doi: 10.1007/s00404-008-0857-3. Epub 2008 Dec 2.

Abstract

Introduction: A pregnant patient, with term intrauterine fetal demise, who developed cardiopulmonary arrest during labor, followed by disseminated intravascular coagulation (DIC) secondary to amniotic fluid embolism (AFE) that was treated with Recombinant Factor VIIa, is presented.

Case report: A 22-year-old Turkish woman was admitted to our antenatal clinic at 39 weeks 6 days of gestation with a complaint of decreased fetal movements for the previous 3 days. Shortly after presentation, she was noted to have circumoral cyanosis with shortness of breath and sudden loss of consciousness. After a 3,220 g macerated male fetus was delivered, persistent bleeding occurred in the mother and was managed with Recombinant Factor VIIa at a dose of 90 mcg/kg. She died 8 days after the admission due to multiple organ failure.

Conclusion: Recombinant Factor VIIa may be a treatment option for hemorrhage in patients with DIC related to AFE.

Publication types

  • Case Reports

MeSH terms

  • Blood Transfusion
  • Disseminated Intravascular Coagulation / drug therapy*
  • Disseminated Intravascular Coagulation / etiology
  • Embolism, Amniotic Fluid* / diagnosis
  • Embolism, Amniotic Fluid* / therapy
  • Factor VIIa / therapeutic use*
  • Fatal Outcome
  • Female
  • Heart Arrest / etiology
  • Humans
  • Multiple Organ Failure / etiology
  • Pregnancy
  • Recombinant Proteins / therapeutic use
  • Stillbirth
  • Young Adult

Substances

  • Recombinant Proteins
  • recombinant FVIIa
  • Factor VIIa