///2019 Abstract Details
2019 Abstract Details2019-07-13T07:45:15-05:00

Caring for Jehovah’s Witnesses Parturient: A Retrospective Chart Review

Abstract Number: T110-554
Abstract Type: Original Research

Jie Zhou MD, MS, MBA, FASA1 ; Yao Zhang MD2

Background

Jehovah’s Witnesses (JW) parturients who are known for their refusal of primary blood components pose unique challenges to anesthesiologists and obstetricians along the process of labor. We conducted a retrospective analysis to identify the treatment patterns and issues that arise during the delivery in this population.

Methods

In the present study, we retrospectively identified cases who were Jehovah’s Witnesses and delivered at Partners HealthCare System from May 2015 to December 2018. Demographic information, acceptance of blood transfusion, types of accepted blood products, hematological supports, as well as clinical data during anesthesia and delivery were reviewed and analyzed. The information of accepted blood products was available from a document in the inpatient’s chart.

Results

A total of 78 JW women experienced 84 deliveries in this cohort. The information about accepted blood products was finally obtained in 51 women. Twenty-three women (46%) expressed refusal of any blood products, whereas approximately 54% of JW patients accepted at least one type of blood products. The acceptable blood product types included albumin, platelets, fresh frozen plasma, cryoprecipitate and fibrinogen concentrate (Table 1). JW women with cesarean delivery accepted more types of blood product than those who delivered vaginally. There were no fatal postpartum hemorrhage and maternal deaths. The mean estimated blood loss at cesarean delivery, and vaginal delivery was 763.8 ± 128.8 mL [range 500–1000 mL] and 317.7 ± 160.5 mL [range 50–800 mL] respectively. The mean cesarean duration from incision to procedure closing was 58.6 ±14.0 min.

Discussion

Our data suggest that there was variability among JW parturients’ willingness to accept the range of blood products. Preprocedural consultation between the Jehovah’s Witness patient and anesthesiologist, obstetrician and/or midwife staff must be conducted early and continued throughout the perinatal period. The mean of estimated blood loss in this study during cesarean and vaginal delivery was lower than the hospital average of approximately 8% and 13% during the study period. The mean duration from incision to procedure closing was also longer than the hospital average. These differences suggested that care providers may hold more awareness of increased mortality of postpartum hemorrhage in this population.

References

1. Mason, et al, 2015

2. Husarova, et al, 2016



SOAP 2019