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Journal of Case Reports
Conservative Blood Management in a Jehovah's Witness with Placenta Percreta: A Case Report and Transfusion Trigger Questioning
Paula Alves Pinheiro,  Marina Ayres Delgado, Camila Biazussi Damasceno,  Isadora Megale Quadros
Department of Anesthesia and Pain Medicine. Hospital das Clínicas de Minas Gerais, Belo Horizonte/Minas Gerais, Brazil.
Corresponding Author:
Dr Marina Ayres Delgado
Email: marina.ayres.delgado@gmail.com
Received: 01-DEC-2020 Accepted: 13-APR-2021 Published Online: 20-MAY-2021
DOI: http://dx.doi.org/10.17659/01.2021.0028
Abstract
Background: Jehovah`s witness is a Christian religion with 8.6 million worldwide members who recognize the Bible as God`s message to humanity. Based on their interpretation of the Bible, blood is seen as holy and sacred and therefore blood component transfusions are not allowed. This is a special concern in cases of severe anemia and non-elective surgeries as there is no time to restore blood storages and reduce the risk of exogenous blood need. Case Report: Here we present the case of a 33-year-old Jehovah`s Witness with an infected miscarriage and placenta percreta confirmed during operation. A nadir of 5.1 g/dL hemoglobin was reached but, despite severe anemia, no hemodynamic instability or increased lactate levels were noticed and no blood components administrated. Conclusion: As blood transfusion carries in itself potential risks and is a special issue in this group of patients this report suggests that blood transfusions should be guided by personal triggers, based on hemodynamic and laboratorial levels associated with age and co-morbidities.

Keywords : Anemia; Blood Transfusion; Blood Component Transfusion, Jehovah`s Witnesses, Pregnancy.
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