Administration of octaplex in comprehensive treatment of patients with profuse obstetrical hemorrhage

Abstract

Actuality. In spite of the advances in up-to-date medicine the treatment of postpartum hemorrhage remains a serious challenge for obstetricians. The incidence of such bleedings comprises up to 9-11% of the total number of deliveries. It is hemorrhage that conditions the fourth part of the causes of maternal mortality, of which over 70% result from disorders of hemostatic system, i.e. it can be considered a manifestation of DIC-syndrome. The incidence of profuse obstetric hemorrhage is 0.5 - 4.5% of the total number of bleedings. The aim was to analyze the effectiveness of administration of therapeutic agent Octaplex in the treatment of profuse obstetric hemorrhage. Materials and methods: the Department of Obstetrics, Gynecology and Children Gynecology assessed feasibility of administration and effectiveness of the therapy with this drug according to the instructions for the employment of medical immunobiological drug Octaplex 500 IU approved by the order issued by the Ministry of Health of Ukraine No.197 from 05.03.2010 Results of the study: The treatment of women with profuse blood loss was aimed both at surgical arrest of bleeding and at urgent replenishment of circulating blood volume. This method is not possible without infusion therapy and administration of drugs, activating hemostasis and preventing the development of coagulopathy. Development of hemorrhagic shock followed by a severe disruption of blood coagulation system is the most severe and life-threatening complication of blood and plasma loss. The action of this drug is aimed at the correction of coagulopathy. It contains several coagulation factors in high concentration: factor II - 220-760 IU, Factor VII - 180-480 IU, Factor IX - 500 IU, Factor X - 360-600 IU, protein S - 140-640 IU, protein C - 140-620 IU, heparin - 100-250 IU. Given the amount of clotting factors it can be said that one bottle of Octaplex 500 IU is equivalent to 1000-1500 ml of fresh frozen plasma. The average amount of blood loss was 950 mL (mean intraoperative blood loss - 620 ml), which corresponds to an average value of 21% of CBV, 1.53% of body weight. Indices of blood clotting before administration of Octaplex 500 IU (INR - 0.78, Quick’s prothrombin - 52.5%, blood clotting time - 5 minutes 41 seconds). Indices of blood clotting after administration of Octaplex 500 IU (INR-1.12, Quick’s prothrombin - 86.3%, blood clotting time - 7 minutes 23 seconds). Conclusion: Octaplex is an effective agent for the treatment of profuse postpartum hemorrhage and corrects coagulopathy.