11 aug. 2008 HEMORAGIILE OBSTETRICALE INSOTITE DE TULBURARI DE COAGULARE
G. Dumitru, G. Bãnceanu
Spitalul Clinic Polizu București
Rezumat
Hemoragia masivã este o cauzã majorã de deces la pacientele obstetricale. Cauzele coagulopatiei la aceste paciente include coagulopatia de consum, hiperfibrinoliza, coagulopatia diluționalã, transfuzia masivã, hipotermia și tulburãrile metabolice ca acidoza sau hipotermia. Recent au fost raportate cazuri în care factorul VII activat (NovoSeven) a controlat hemoragia la pacientele cu hemoragii massive, necontrolabil, în ciuda corecției chirurgicale și a înlocuirii volumului circulant cu derivate de sânge.
Abstract
Hemorrhage is a major cause of obstetrical-related death. Causes of coagulopathy in these patients include consumption coagulopathy, hyperfibrinolysis, dilutional coagulopathy, massive transfusions, hypothermia, and metabolic factors such as acidosis and hypocalcemia. Recently, reports have been accumulating about the use of recombinant activated factor VII (NovoSeven) to control hemorrhage in patients experiencing active, massive, uncontrolled bleeding, during or shortly after surgery, despite surgical hemostasis and replacement with blood-derived products.