Overview on the use of recombinant factor VIIa in obstetrics and gynecology

Sandro Scarpelini Post-doctoral Fellow at Sunnybrook Health Sciences Centre and Assistant Professor of Trauma and Emergency Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil and Post-doctoral Fellow at the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq, Brazil, University of Toronto, Sunnybrook Health Sciences Centre Ontario,2075 Bayview Ave, Suite H1-71, M4N 3M5 Toronto, Canada.

Bartolomeu Nascimento Critical Care Fellow, University of Toronto, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Suite H1-71, M4N 3M5 Toronto, Ontario, Canada.

Homer Tien Lecturer in Surgery, University of Toronto, Department of Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Suite H1-71, M4N 3M5 Toronto, Ontario, Canada.

Fernando AC Spencer Netto Trauma Surgery Fellow, University of Toronto, Department of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Suite H1-71, M4N 3M5 Toronto, Ontario, Canada.

Lorraine Tremblay Assistant Professor of Surgery and Critical Care Medicine, University of Toronto, Department of Surgery and Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Suite H1-71, M4N 3M5 Toronto, Ontario, Canada.

Sandro Rizoli Assistant Professor of Surgery and Critical Care Medicine, University of Toronto, Department of Surgery and Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Suite H1-71, M4N 3M5 Toronto, Ontario, Canada. [email protected]

Abstract

Bleeding remains a major cause of morbidity and mortality in obstetrics and gynecology. A unique drug, recombinant factor VIIa (rFVIIa), has been introduced recently for the management of surgical bleeding. This novel application of a drug that was restricted to hemophilia treatment for over 10 years has generated intense interest among surgeons. This article reviews the importance of bleeding in obstetrics and gynecology, the characteristics of this drug, including side effects, and all the evidence available on rFVIIa use in obstetrics and gynecology. Expert commentary on rFVIIa is presented with recommendations on its clinical application. rFVIIa is a fascinating adjunct therapy that is undergoing rapid and extensive investigation. rFVIIa has the potential to change the current standards of hemorrhage care in surgical patients, including obstetrics and gynecology patients.

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Acknowledgements

The authors thank Cyndy Rogers for HER invaluable support with patient data.

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Overview on the use of recombinant factor VIIa in obstetrics and gynecology

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Overview on the use of recombinant factor VIIa in obstetrics and gynecology

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