<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412018001200779</article-id>
<article-id pub-id-type="doi">10.24245/gom.v86i12.2312</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Indicaciones del factor VII recombinante activado en hemorragia obstétrica grave]]></article-title>
<article-title xml:lang="en"><![CDATA[Use of recombinant activated Factor VII in severe obstetric hemorrhage]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Corona-Gutiérrez]]></surname>
<given-names><![CDATA[América Aime]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Ruan]]></surname>
<given-names><![CDATA[Karen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camarena-Pulido]]></surname>
<given-names><![CDATA[Eva Elizabet]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Aceves]]></surname>
<given-names><![CDATA[Luis Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Moreno]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fajardo-Dueñas]]></surname>
<given-names><![CDATA[Sergio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Civil de Guadalajara Dr. Juan I. Menchaca  ]]></institution>
<addr-line><![CDATA[Guadalajara Jalisco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Civil de Guadalajara Dr. Juan I. Menchaca  ]]></institution>
<addr-line><![CDATA[Guadalajara Jalisco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Civil de Guadalajara Dr. Juan I. Menchaca  ]]></institution>
<addr-line><![CDATA[Guadalajara Jalisco]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<volume>86</volume>
<numero>12</numero>
<fpage>779</fpage>
<lpage>786</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412018001200779&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412018001200779&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412018001200779&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  OBJETIVO: Describir la situación final de salud de las pacientes con hemorragia obstétrica grave (&#8805; 1000 mL) en quienes se indicó factor VII recombinante activado como parte del tratamiento e identificar las complicaciones atribuibles a este medicamento.  MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo efectuado en pacientes con hemorragia obstétrica grave atendidas en el Hospital Civil de Guadalajara Dr. Juan I Menchaca entre 2001 y 2017 y tratadas con factor VII recombinante activado. Se identificaron los antecedentes de importancia y se calculó la dosis promedio y cantidad de dosis de factor VII recombinante activado; se valoró la respuesta hemostática y se determinó si la diferencia en cantidad de sangrado, administración de hemoderivados y parámetros hematológicos antes y después de utilizar factor VII recombinante activado fue significativa.  RESULTADOS: Se identificaron 10 pacientes en quienes se aplicó factor VII recombinante activado. La causa de hemorragia obstétrica grave fue atonía uterina en seis casos. La dosis promedio de factor VII recombinante activado fue de 91 mcg/kg. En 8 pacientes se administró una dosis y 2 dosis en 2 pacientes. En todas las pacientes se logró la hemostasia; el sangrado disminuyó significativamente posterior a la administración del factor VII recombinante activado (5075 vs 928 mL; p = 0.000) lo mismo que la cantidad de concentrados eritrocitarios trasfundidos (7 vs 3; p = 0.006). Una paciente no requirió histerectomía, otra tuvo tromboembolia pulmonar, que se trató sin problemas y ninguna paciente falleció.  CONCLUSIÓN: El factor VII recombinante activado como hemostático en hemorragia obstétrica grave mostró resultados favorables y evitó la histerectomía en una paciente. Requiere vigilancia estrecha de las complicaciones trombóticas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  OBJECTIVE: To describe outcome of patients with severe obstetric hemorrhage (&#8805; 1000 mL) treated with rFVIIa as part of the management and to detect complications related to its use.  MATERIALS AND METHODS: Retrospective, cross-sectional and descriptive study carried out in patients with severe obstetric hemorrhage treated at the Hospital Civil de Guadalajara Dr. Juan I Menchaca between 2001 and 2017 and treated with activated recombinant factor VII. We identified relevant antecedents, average dose and number of doses of rFVIIa, and hemostatic response. We determined if quantity of bleeding, administration of blood products and hematological parameters before and after using rFVIIa was significantly different.  RESULTS:  We identified ten patients with rFVIIa administration. The cause of severe obstetric hemorrhage was uterine atony in six cases. The average dose of rFVIIa was 91 mcg/kg; one dose was administered in eight patients and two doses in two patients. Hemostasis was achieved in all patients, bleeding decreased significantly after administration of rFVIIa (5075 mL vs 928 mL, p = 0.000) and the number of erythrocyte concentrates required 7vs 3, p = 0.006). One patient did not require a hysterectomy after rFVIIa administration; one patient presented pulmonary thromboembolism and recovered without complications, no patient died.  CONCLUSION:  rFVIIa administration as a hemostatic in severe obstetric hemorrhage had favorable results, preventing hysterectomy in one patient. Follow-up requires close monitoring of thrombosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[FVIIa recombinante]]></kwd>
<kwd lng="es"><![CDATA[atonía uterina]]></kwd>
<kwd lng="es"><![CDATA[hemostasia]]></kwd>
<kwd lng="es"><![CDATA[proteínas recombinantes]]></kwd>
<kwd lng="es"><![CDATA[histerectomía]]></kwd>
<kwd lng="en"><![CDATA[Recombinant FVIIa]]></kwd>
<kwd lng="en"><![CDATA[Uterine inertia]]></kwd>
<kwd lng="en"><![CDATA[Hemostasis]]></kwd>
<kwd lng="en"><![CDATA[Hemostatics]]></kwd>
<kwd lng="en"><![CDATA[Recombinant proteins]]></kwd>
<kwd lng="en"><![CDATA[Hysterectomy]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>Dirección General de Epidemiología, Subsecretaría de Prevención y Promoción de la Salud</collab>
<source><![CDATA[Informe semanal de vigilancia epidemiológica: Información relevante muertes maternas. Semana epidemiológica 52]]></source>
<year>2018</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[SINAVE]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<collab>Secretaría de Salud</collab>
<source><![CDATA[Prevención y manejo de la hemorragia posparto en el primer, segundo y tercer niveles de atención]]></source>
<year>2018</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[CENETEC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="">
<source><![CDATA[Recomendaciones de la OMS para la prevención y el manejo de la hemorragia posparto]]></source>
<year>2014</year>
<publisher-loc><![CDATA[Suiza ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Franchini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The use of recombinant activated FVII in postpartum hemorrhage]]></article-title>
<source><![CDATA[Clin Obstet Gynecol]]></source>
<year>2010</year>
<volume>53</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>219-27</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moscardó]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Successful treatment of severe intra-abdominal bleeding associated with disseminated intravascular coagulation using recombinant activated factor VII]]></article-title>
<source><![CDATA[Br J Haematol]]></source>
<year>2001</year>
<volume>113</volume>
<page-range>174-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kenet]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of traumatic bleeding with recombinant factor VIIa]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>1999</year>
<volume>354</volume>
<page-range>1879</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hardy]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Efficacy and safety of recombinant activated factor VII to control bleeding in nonhemophiliac patients: a review of 17 randomized controlled trials]]></article-title>
<source><![CDATA[Ann Thorac Surg]]></source>
<year>2008</year>
<volume>86</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1038-48</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="">
<collab>Novo Nordisk</collab>
<source><![CDATA[NovoSeven(r) RT (coagulation factor VIIa [recombinant] room temperature stable) prescribing information]]></source>
<year>2014</year>
<edition>Version: 20140702-V13</edition>
<publisher-loc><![CDATA[EEUU ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Duffy]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines for use of recombinant factor VIIa in life-threatening post-partum haemorrhage]]></article-title>
<source><![CDATA[Int J Obstet Anesth]]></source>
<year>2007</year>
<volume>16</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>299-300</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Welsh]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines for the use of recombinant activated factor VII in massive obstetric haemorrhage]]></article-title>
<source><![CDATA[Aust N Z J Obstet Gynaecol]]></source>
<year>2008</year>
<volume>48</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>12-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahonen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of recombinant activated factor VII in obstetric hemorrhage]]></article-title>
<source><![CDATA[Curr Opin Anaesthesiol]]></source>
<year>2012</year>
<volume>25</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>309-14</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alfirevic]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of recombinant activated factor VII in primary postpartum hemorrhage the Northern European registry 2000-2004]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>2007</year>
<volume>110</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1270-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lavigne-Lissalde]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recombinant human FVIIa for reducing the need for invasive second-line therapies in severe refractory postpartum hemorrhage: a multicenter, randomized, open controlled trial]]></article-title>
<source><![CDATA[J Thromb Haemost]]></source>
<year>2015</year>
<volume>13</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>520-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schjoldager]]></surname>
<given-names><![CDATA[BTBG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Topical application of recombinant activated factor VII during cesarean delivery for placenta previa]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2017</year>
<volume>216</volume>
<numero>6</numero>
<issue>6</issue>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wong-Phillips]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recombinant activated factor VII in obstetric hemorrhage experiences from the Australian and New Zealand Haemostasis Registry]]></article-title>
<source><![CDATA[Anesth Analg]]></source>
<year>2009</year>
<volume>109</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1908-15</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Blatný]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe postpartum haemorrhage treated with recombinant activated factor VII in 80 Czech patients: analysis of the UniSeven registry]]></article-title>
<source><![CDATA[Int J Obstet Anesth]]></source>
<year>2011</year>
<volume>20</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>367-8</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murakami]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experience with recombinant activated factor VII for severe post-partum hemorrhage in Japan, investigated by Perinatology Committee, Japan Society of Obstetrics and Gynecology]]></article-title>
<source><![CDATA[J Obstet Gynaecol Res]]></source>
<year>2015</year>
<volume>41</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1161-8</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
