Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

. 2018 Apr 26;78(4):382–399. doi: 10.1055/a-0582-0122

Consensus-based Recommendation 9.E32
Although the data is controversial and prospective randomised studies are lacking, one or two attempts at treatment with rFVIIa at a dose of 90 µg/kg BW can be undertaken as a last resort in carefully selected cases if the patient has previously received adequate and appropriate treatment with other blood products, the other methods used for haemostasis were not sufficiently effective, and the patient still wants to have other children before undergoing a hysterectomy 39 , 113 , 114 , 115 , 116 . Because of the risk of thromboembolism, recombinant FVIIa (NovoSeven ^® ) should only be given as a last resort 117 . Plasmatic factor concentrations and platelet numbers should be optimised before rFVIIa is administered 46 .

Consensus-based Recommendation 9.E32

Expert consensus

Level of consensus +++

Although the data is controversial and prospective randomised studies are lacking, one or two attempts at treatment with rFVIIa at a dose of 90 µg/kg BW can be undertaken as a last resort in carefully selected cases if

the patient has previously received adequate and appropriate treatment with other blood products,
the other methods used for haemostasis were not sufficiently effective, and
the patient still wants to have other children before undergoing a hysterectomy 39 , 113 , 114 , 115 , 116 .

Because of the risk of thromboembolism, recombinant FVIIa (NovoSeven ^® ) should only be given as a last resort 117 . Plasmatic factor concentrations and platelet numbers should be optimised before rFVIIa is administered 46 .