In case of extensive surgical injury, transfusions of blood and blood products can lead to dilution coagulopathy. Manifestations of dilute coagulopathy include fibrinolysis, hypofibrinogenemia, and dilute thrombocytopenia, all of which are involved in bleeding.
The development of dilute coagulopathy during surgical bleeding can be effectively prevented by rFVIIa administration. Although there are no randomized trials of this drug in gynecological surgery, case reports suggest that its use should be considered as a last resort in life-threatening situations.