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The role of recombinant factor VIIa for obstetric block in women with severe factor XI deficiency
Author(s) -
SETTY S.,
REDDELL A.,
ENGLAND A.,
GOMEZ K.,
KADIR R.
Publication year - 2011
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2011.02525.x
Subject(s) - medicine , thromboelastometry , recombinant factor viia , epidural block , regional anesthesia , coagulation , anesthesia , coagulopathy , surgery
Summary. Regional blocks like spinal, epidural and combined spinal epidural (CSE) are relatively contraindicated in individuals with bleeding disorders. Consequently pregnant women with severe factor XI (FXI) deficiency are often denied this option during labour and caesarean section. We describe three women with severe FXI deficiency in whom regional block was performed with low‐dose recombinant factor VIIa (rFVIIa) for their operative procedures during delivery. All women achieved haemostasis and had uncomplicated regional block, delivery and surgical procedures. The point of care device – rotational thromboelastometry (ROTEM) was used to monitor the patients’ coagulation and determine the dose of rFVIIa to achieve in vitro haemostasis in these women that was then subsequently used in vivo. Low‐dose rFVIIa seems to be effective and safe in the management of delivery and enables provision of regional blocks in women with severe FXI deficiency.