ABSTRACT
【Objective】 To investigate the effects of recombinant human coagulation factor Ⅶa combined with Bakri balloon compression on oxidative stress and coagulation in patients with refractory postpartum hemorrhage. 【Methods】 Prospectively, 80 patients with refractory postpartum hemorrhage in Chengdu Fifth People′s Hospital from June 2019 to June 2022 were selected and grouped according to the random number table method. The control group (n=40) was treated with Bakri balloon compression, and the observation group (n=40) was treated with recombinant human coagulation factor Ⅶa combined with Bakri balloon compression. The bleeding-related indexes and adverse effects were observed in both groups, and the prenatal and 24 h postpartum oxidative stress, coagulation function and inflammatory factors were compared between the two groups. 【Results】 The blood loss in the observation group and the control group was (683.96±146.52) vs(796.63±152.41)mL during operation, (812.46±161.53) vs(965.39±166.22)mL in 2 h after delivery, (899.53±178.74) vs(1 084.31±203.67)mL in 24 h after delivery, and the transfusion volume was (512.31±104.76) vs(683.25±113.52)mL, and the onset time of hemostasis was (14.63±3.18) vs (21.72±5.29) min (P0.05). At 24 h postpartum, NE, Cor, SOD and MDA were higher than those before delivery in both groups, but the observation group was lower than the control group (P<0.05); TT, APTT and PT were longer and Fib was lower in both groups than before delivery, but TT, APTT and PT were shorter and Fib was higher in the observation group than in the control group (P<0.05); CRP, IL-8 and TNF-α were higher in both groups than before delivery, but the observation group was lower than in the control group (P<0.05). 【Conclusion】 Hemostasis in patients with refractory postpartum hemorrhage treated with recombinant human coagulation factor Ⅶa combined with Bakri balloon compression was effective, which can improve coagulation, reduce transfusion, decrease oxidative stress injury and inflammatory response without increasing adverse effects.
ABSTRACT
Massive postpartum hemorrhage is one of the most severe complications of pregnant women during deliveries, especially, on the basis of a scarred uterus with placenta previa and placenta implantation, the risk of occurrence of massive hemorrhage after delivery will be obviously increased. The recombinant human coagulation factorⅦa (rFⅦa) can be used to significantly reduce the incidence of delutional coagulopathy and the necessary amount of blood products in patients after major abdominal surgery. One patient with massive postpartum hemorrhage resulted from scarred uterus with placenta previa and previa accreta was administered into Guizhou Medical University Affiliated Hospital, whose hemorrhage was successfully stopped by using rFⅦa in case of surgical indication being excluded. It is suggested that rFⅦa can be regarded as an effective drug for postpartum hemorrhage on the basis of indication being strictly controlled.
ABSTRACT
Massive postpartum hemorrhage is one of the most severe complications of pregnant women during deliveries, especially, on the basis of a scarred uterus with placenta previa and placenta implantation, the risk of occurrence of massive hemorrhage after delivery will be obviously increased. The recombinant human coagulation factorⅦa (rFⅦa) can be used to significantly reduce the incidence of delutional coagulopathy and the necessary amount of blood products in patients after major abdominal surgery. One patient with massive postpartum hemorrhage resulted from scarred uterus with placenta previa and previa accreta was administered into Guizhou Medical University Affiliated Hospital, whose hemorrhage was successfully stopped by using rFⅦa in case of surgical indication being excluded. It is suggested that rFⅦa can be regarded as an effective drug for postpartum hemorrhage on the basis of indication being strictly controlled.