Primary postpartum hemorrhage is one of the most common causes of maternal death. Recombinant factor VIIa is a safe and effective drug for the treatment of bleeding episodes in patients with coagulation deficiencies. Its use in patients with severe bleeding without known coagulation factor deficiencies or (preexisting) bleeding disorders has been described only in a few case reports. These authors present a case of severe primary postpartum hemorrhage treated with recombinant factor VIIa at an early stage in addition to standard medical intervention.

Primary postpartum hemorrhage, defined as bleeding from the genital tract of 500 mL or more in the first 24 hours after childbirth, is one of the most common causes of maternal death worldwide. Although the maternal mortality of primary postpartum hemorrhage is lower in European countries (1 in 100 000 deliveries) than in developing countries (1 in 1000 deliveries),1 postpartum blood loss still results in severe...

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