Sequence of application of prothrombin complex concentrate and blood coagulation factors in obstetric bleedings (clinical cases)

Currently, in the intensive care of coagulopathy, as a clinical manifestation of massive obstetric bleeding, plasma and recombinant concentrates of factors of the blood coagulation system are used with good effect, which include, respectively, the concentrate of the prothrombin complex "Prothromplex 600" and the recombinant factor (rFVIIa) "Coagil-VII". When regulating the interaction of drugs, the simultaneous administration of the prothrombin complex concentrate and rFVIIa is not recommended, due to the lack of knowledge of the interaction of these categories of drugs (as well as with antifibrinolytics), while in the instructions for the use of the prothrombin complex concentrate there are no direct indications of the undesirability of using it with rFVIIa. The cases cited by the authors of the sequential use of prothrombin complex concentrate and rFVIIa confirm the presence of clear indications for their use, as well as the possibility of consistent use in compliance with the requirements of dynamic laboratory monitoring in women with massive obstetric bleeding caused by an abnormal location of the placenta and amniotic fluid embolism.