Case Series: Recombinant factor VIIa utilized in successful treatment of disseminated intravascular coagulation secondary to anaphylactoid syndrome of pregnancy

Ira Stanley Frye, Casey Sager, Alicia Daly, Pierre Barbot, Elizabeth Luce, Liana Rinzler, Gareth K Forde


BACKGROUND: Anaphylactoid syndrome of pregnancy (ASP), also known as amniotic fluid embolism (AFE) is a rare, yet life-threatening complication of pregnancy. In about half the cases, disseminated intravascular coagulation (DIC) occurs with ASP. Recombinant factor VIIa treatment has been successfully used a few times in the past to treat DIC associated with ASP.
CASES: Case 1 details a 36-year-old woman at 39 weeks and 2 days gestation that developed seizures, hypotension and bradycardia with noted fetal distress following an augmentation of labor. Case 2 describes a 30 year-old woman who presented for a scheduled induction of labor at 39 weeks and 1 day gestation and experienced sudden onset of severe back pain, shortness of breath, and tachycardia. Both women developed disseminated intravascular coagulapathy (DIC), which was successfully managed with recombinant factor VIIa.
CONCLUSION: Recombinant factor VIIa treatment has some risks, but is cases such as the two women presented in this report, its use can be lifesaving.


Anaphylactiod syndrome of pregnancy, DIC, recombinant factor VIIa

Full Text: