Prophylactic use of a recombinant activated factor VII in delivery haemorrhage by caesarean in a woman with major factor VII deficiency: a case report
| Autor: | J. Devignes, Thomas Lecompte, M. E. Briquel, Jean-François Comes, Olivier Thiebaugeorges |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty Factor VII Deficiency Factor VIIa Postoperative Hemorrhage Chemoprevention Severity of Illness Index chemistry.chemical_compound Pregnancy hemic and lymphatic diseases medicine Humans cardiovascular diseases Factor VII Cesarean Section business.industry Pregnancy Complications Hematologic Retrospective cohort study General Medicine Delivery Obstetric medicine.disease Thrombosis Recombinant Proteins Hematochezia Appendicitis Obstetric Labor Complications Pedigree Surgery chemistry Gestation Female medicine.symptom Complication business |
| Zdroj: | Annales de biologie clinique. 69:713-719 |
| ISSN: | 0003-3898 |
| Popis: | Taking in charge the delivery of pregnant women with inherited major deficiency of factor VII (FVII) is poorly reported in literature. We report here the haemorrhagic prophylaxis of delivery by recombinant activated FVII (rFVIIa) in a 27-year-old women, gravida 1, para 0, with major deficiency FVII by missense mutation (p.Arg337Cys). Her parents, first germen, presented a FVII deficiency. She has four brothers and three sisters, of which only one brother has major FVII deficiency with hemorrhagic diathesis in childhood (hematochezia). At her birth, because of dystocia, a right sterno-cleido-mastoid muscle hematoma and left clavicle fracture occurred. The FVII concentration was 0.08 U/mL. At the age of fifteen, a surgery of appendicitis was performed with substitution by FVII from plasma donors without any haemorrhagic complication. Because of anatomic specificity (bifid uterus and vagina), caesarean was planned. After reviewing of the literature, caesarean was performed at 38th week of gestation with haemorrhagic prophylaxis consisting in administration of rFVIIa (eptacog alfa) at a dose of 20 μg/kg, 30 min before surgery, then every 3 h during 48 h. No haemorrhagic complication occurred. Thrombosis prophylaxis was ensured by enoxaparin (4000 UI a day subcutaneously started 6 h after surgery for 5 days). Clinical examination of the newborn was normal. In future, modalities of taking in charge have to be evaluated by prospective studies involving a sufficiently numerous group of woman with FVII major deficiency, or by retrospective studies with the means of national or European registers. |
| Databáze: | OpenAIRE |
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