Obstetric Surgery with High Risk of Postpartum Hemorrhage in a Jehovah’s Witness

Authors

  • Maria Carp Serviço de Anestesiologia. Hospital Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisboa.
  • Sandra Maurício Serviço de Anestesiologia. Instituto Português de Oncologia de Lisboa. Lisboa.
  • Filipa Lança Serviço de Anestesiologia. Hospital Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisboa.

DOI:

https://doi.org/10.20344/amp.12763

Keywords:

Jehovah’s Witnesses, Postpartum Hemorrhage/prevention & control, Tranexamic Acid

Abstract

Postpartum Hemorrhage is still the leading cause of maternal mortality. The management of patients who refuse allogeneic blood transfusion, like in the case of Jehovah’s Witnesses, is clinically and ethically challenging. We describe the case of a woman with several risk factors for major postpartum hemorrhage, specifically the presence of a giant uterine myoma. The multidisciplinary management of this patient included an elective c-section and the use of prophylactic tranexamic acid. The perioperative and peripartum care of Jehovah’s Witnesses requires specific strategies to minimize blood loss, optimize oxygen delivery and consumption, enhance hemoglobin production, correct coagulation defects and promote hemostasis. We highlight the need for a multidisciplinary approach, point-of-care testing and the use of fibrinogen concentrate and tranexamic acid, according to the patients’ informed consent.

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Published

2021-03-31

How to Cite

1.
Carp M, Maurício S, Lança F. Obstetric Surgery with High Risk of Postpartum Hemorrhage in a Jehovah’s Witness. Acta Med Port [Internet]. 2021 Mar. 31 [cited 2024 Apr. 23];34(4):300-3. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12763

Issue

Section

Case Report