title: Successful Resuscitation Following Massive Obstetric Hemorrhage in a Patient of the Jehovah's Witness Faith: A Case Report.
abstract: Hemorrhage is a leading cause of maternal morbidity and mortality worldwide. It is especially difficult to treat in patients of the Jehovah's Witness faith because they refuse certain blood products. This case report describes the resuscitation of a parturient Jehovah's Witness whose postcesarean delivery course was complicated by massive hemorrhage from unrecognized arterial bleeding in the intensive care unit with significant hemodynamic instability that necessitated an emergency bedside laparotomy. Her hemoglobin nadir was 1.5 mg/dL. The case demonstrates the key place of preprocedure planning, blood conservation, and coagulation factor management in this specific patient population.
authors.affiliation: From the Departments of *Anesthesiology; †Anesthesiology & McGowan Institute for Regenerative Medicine; and ‡Pathology & Institute for Transfusion Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Hubbard
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Waters
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yazer
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001804:Blood Transfusion, Autologous; D017604:Cesarean Section, Repeat / Q000009:adverse effects*; D003131:Combined Modality Therapy; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion; D005260:Female; D005440:Fluid Therapy; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D033221:Jehovah's Witnesses; D057725:Operative Blood Salvage; D006473:Postpartum Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012068:Religion and Medicine; D012151:Resuscitation / Q000379:methods*; D016896:Treatment Outcome; D016312:Treatment Refusal; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D006454:Hemoglobins; D014662:Vasoconstrictor Agents