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

• Autor(a) principal: Carp, Maria
• Data de Publicação: 2021
• Outros Autores: Maurício, Sandra, Lança, Filipa
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12763
• topic: Jehovah’s Witnesses; Postpartum Hemorrhage/prevention & control; Tranexamic Acid; Ácido Tranexâmico; Hemorragia Pós-Parto/prevenção e controlo; Testemunhas de Jeová

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.