Abstract
Objective: The purpose of this study was to determine the rates of obstetric hemorrhage and
maternal mortality in women who are Jehovah's Witnesses and to evaluate a protocol
that uses erythropoietin to optimize the red blood cell mass before delivery. Study Design: Obstetric outcomes were described for all of the women who were Jehovah's Witnesses
and who delivered at Mount Sinai Medical Center during an 11-year period. The risk
of maternal death was compared with our general obstetric population during this interval.
Results: A total of 332 women who were Jehovah's Witnesses had 391 deliveries. An obstetric
hemorrhage was experienced in 6% of this population. There were 2 maternal deaths
among the women who were Jehovah's Witnesses, for a rate of 512 maternal deaths per
100,000 live births versus 12 maternal deaths per 100,000 live births (risk ratio,
44; 95% CI, 9-211). Erythropoietin was associated with a nonsignificant increase in
hematocrit level. Conclusion: Women who are Jehovah's Witnesses are at a 44-fold increased risk of maternal death,
which is due to obstetric hemorrhage. Patients should be counseled about this risk
of death, and obstetric hemorrhage should be aggressively treated, including a rapid
decision to proceed to hysterectomy when indicated. (Am J Obstet Gynecol 2001;185:
893-5.)
Keywords
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Article Info
Footnotes
*Reprint requests: Carl J. Saphier, MD, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, 5 East 98th St, Box 1170, New York, NY 10029.E-mail: [email protected] .
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.