TY - JOUR
T1 - Recombinant factor VIIa in management of spontaneous subcapsular liver hematoma associated with pregnancy.
AU - Merchant, Shakil H.
AU - Mathew, Prasad
AU - Vanderjagt, Timothy J.
AU - Howdieshell, Thomas R.
AU - Crookston, Kendall P.
PY - 2004/5
Y1 - 2004/5
N2 - BACKGROUND: Spontaneous subcapsular liver hemorrhage is a rare but life-threatening complication of pregnancy. Optimal management of an expanding hematoma or ruptured capsule has not been established. CASES: We report 3 patients with preeclampsia and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome with spontaneous subcapsular liver hematomas. The first 2 patients with ruptured liver hematomas experienced life-threatening hemorrhage. The third patient experienced uncontrollable vaginal bleeding, liver hemorrhage, and was in imminent danger of capsule rupture. Despite aggressive surgical intervention and traditional blood component therapy, adequate hemostasis could not be achieved in any of these patients. Recombinant factor VIIa was used to achieve hemostasis in all three patients. CONCLUSION: Recombinant factor VIIa is an effective adjunct in the treatment of preeclamptic patients with expanding or ruptured subcapsular liver hematoma.
AB - BACKGROUND: Spontaneous subcapsular liver hemorrhage is a rare but life-threatening complication of pregnancy. Optimal management of an expanding hematoma or ruptured capsule has not been established. CASES: We report 3 patients with preeclampsia and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome with spontaneous subcapsular liver hematomas. The first 2 patients with ruptured liver hematomas experienced life-threatening hemorrhage. The third patient experienced uncontrollable vaginal bleeding, liver hemorrhage, and was in imminent danger of capsule rupture. Despite aggressive surgical intervention and traditional blood component therapy, adequate hemostasis could not be achieved in any of these patients. Recombinant factor VIIa was used to achieve hemostasis in all three patients. CONCLUSION: Recombinant factor VIIa is an effective adjunct in the treatment of preeclamptic patients with expanding or ruptured subcapsular liver hematoma.
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U2 - 10.1097/01.aog.0000127943.68645.96
DO - 10.1097/01.aog.0000127943.68645.96
M3 - Article
C2 - 15121606
AN - SCOPUS:2542428675
SN - 0029-7844
VL - 103
SP - 1055
EP - 1058
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 5 Pt 2
ER -