Sequential application of recombinant factors of blood coagulation system in intensive therapy of massive bleeding due to amniotic fluid embolism

Amniotic fluid embolism (AFE) is one of the most severe complications of pregnancy, childbirth and early postnatal period, being associated with high risk of maternal mortality. AFE manifests as significant coagulopathy with hypocoagulation and activation of fibrinolytic system. In recent years, coagulopathy caused by amniotic fluid entry into maternal circulation is successfully treated with recombinant coagulation factors, including prothrombin complex concentrate, and activated blood coagulation factor Vila (Eptacog alfa activated). Authors present a case of successful sequential use of the above-mentioned blood coagulation factors for combined treatment of coagulopathic syndrome in patient with AFE, which clinically manifested during early postoperative period after delivery with caesarean section. The aim of this article is to demonstrate that above-mentioned drugs are not identical and to prove that all of them should be used only when clinical indications are present, confirmed by results of laboratory studies.