title: Massive obstetric hemorrhage in a Jehovah's Witness: intraoperative strategies and high-dose erythropoietin use.
abstract: A massive obstetric hemorrhage resulting in an extremely low hematocrit (5.9%) required innovative intraoperative and postoperative management. We used a combination of rapid intraoperative volume replacement, aortic compression, chemical coma, high-dose erythropoietin, and enteral iron replacement to elevate the hematocrit in a patient refusing blood transfusions.
authors.affiliation: Obstetrics and Gynecology Clinic, Maternal Fetal Medicine, University of Utah Health Science Center, Salt Lake City, UT 84124, USA. michael.belfort@hcahealthcare. com
authors.forename: Michael
authors.initials: M
authors.lastname: Belfort
authors.forename: Shalece
authors.initials: S
authors.lastname: Kofford
authors.forename: Michael
authors.initials: M
authors.lastname: Varner
mesh_terms: D000328:Adult; D001804:Blood Transfusion, Autologous; D054810:Deep Sedation; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D033221:Jehovah's Witnesses; D010921:Placenta Accreta / Q000628:therapy*; D010923:Placenta Previa / Q000628:therapy*; D011247:Pregnancy; D016312:Treatment Refusal
chemical_list: D004921:Erythropoietin