Abstract
Postpartum hemorrhage remains the leading cause of maternal morbidity and mortality in Japan. Recombinant activated factor Ⅶ (rFⅦa) has been used off-label to treat life-threatening obstetrical bleeding, but the use of rFⅦa should be considered only when first-line treatment with a combination of blood products and surgical approaches fails to control bleeding. An initial dose of 90 µg/kg is administered intravenously within 2 to 5 minutes. Patients with higher fibrinogen (≥100 mg/dL) and platelet levels (≥50,000/μL) seem to respond better to rFⅦa. Since tranexamic acid is an antifibrinolytic agent, administration of rFⅦa combined with tranexamic acid might be a risk factor for thrombotic adverse events, so excessive use of tranexamic acid should be avoided.
