• Tomoyoshi Nohira, Yumi Osakabe, Shingo Suda, Chie Takahashi, Asashi Tanaka, Kazumi Ikeda, Toshiaki Ikeda, and Kazuhiro Okabe.
• Department of Obstetrics and Gynecology, Hachioji Medical Center of Tokyo Medical University, Tokyo, Japan. tnohira@mac.com
• J. Obstet. Gynaecol. Res. 2008 Aug 1;34(4 Pt 2):623-30.

AbstractPostpartum hemorrhage (PPH) is a life-threatening emergency in obstetrics. Although recombinant activated factor VII (rFVIIa) has become used for the treatment of some cases of massive hemorrhage, its applications in the field of obstetrics are still limited. We describe a case of successful treatment with rFVIIa for PPH due to placenta accreta. The patient was a 33-year-old woman with placental previa. Cesarean section (CS) was performed at gestational week 35. During CS, there was massive hemorrhage due to placenta accreta. After CS, disseminated intravascular coagulopathy and hypovolemic shock were diagnosed. The PPH was not controlled by transfusion therapy. On the fourth day after CS, rFVIIa (90 microg/kg x 2) was given because of the persistent PPH. Bleeding decreased and no further transfusion was required from 2 days after administration. rFVIIa was useful in the treatment of this case of obstetric hemorrhage.

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