Massive obstetric hemorrhage in a Jehovah's Witness: intraoperative strategies and high-dose erythropoietin use.
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.
Belfort
Michael
M
Obstetrics and Gynecology Clinic, Maternal Fetal Medicine, University of Utah Health Science Center, Salt Lake City, UT 84124, USA. michael.belfort@hcahealthcare. com
Kofford
Shalece
S
Varner
Michael
M
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
D004921:Erythropoietin