Obstetric outcomes and acceptance of alternative therapies to blood transfusion by Jehovah’s Witnesses in Japan: a single-center study
Obstetric outcomes and acceptance of alternative therapies to blood transfusion by Jehovah’s Witnesses in Japan: a single-center study
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DOI：
10.1007/s12185-018-2490-7
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发表时间：
2018-06
影响因子：
2.1
通讯作者：
Mie Tanaka;S. Matsuzaki;M. Endo;A. Kakigano;K. Mimura;T. Takiuchi;T. Miyake;T. Tomimatsu;Y. Ueda;T. Kimura
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文献类型：
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作者：
Mie Tanaka;S. Matsuzaki;M. Endo;A. Kakigano;K. Mimura;T. Takiuchi;T. Miyake;T. Tomimatsu;Y. Ueda;T. Kimura
我们试图调查日本一家机构中耶和华见证人(JW)对血液产品或自体输血类型的产科结局和接受率。我们回顾了2001年4月至2017年8月84例妊娠JW患者和95例分娩的病例。我们检查了经历产后出血(PPH)的患者对输血、血液制品和自体输血类型的接受率，并调查了分娩和PPH治疗时估计的出血量。84例JW患者中，无一例接受输血，但75例(89.3%)接受了血液制品，57例(67.9%)接受了术中细胞回收自体输血，4例(4.8%)拒绝接受所有替代输血。此外，在95次分娩中，有18次(18.9%)出现了PPH >； 1000mL.在这18名患者中，4名(22.2%)需要血液制品，3名(16.7%)需要宫颈上子宫切除术来控制PPH。没有产妇死亡。约95%的观察患者接受了全部或部分输血替代方案。为了以更安全的方式治疗JW患者，了解他们个人对输血替代品的接受程度对于战略上使用这种替代品非常重要。
We sought to investigate obstetric outcomes and acceptance rates for blood products or types of autotransfusion by Jehovah’s Witnesses (JWs) at a single institution in Japan. We retrospectively reviewed cases of 84 pregnant JW patients and 95 deliveries from April 2001 to August 2017. We examined the acceptance rates of blood transfusions, blood products, and autotransfusion types in patients who experienced postpartum hemorrhage (PPH), and investigated estimated hemorrhage volume at delivery and PPH treatments. Of the 84 JW patients, none accepted blood transfusion; however, 75 patients (89.3%) accepted blood products, 57 (67.9%) accepted autotransfusion using intraoperative cell salvage, and four (4.8%) refused all alternatives to blood transfusion. Furthermore, PPH > 1000 mL occurred in 18 of the 95 (18.9%) deliveries. Of these 18 patients, four (22.2%) required blood products and three (16.7%) required supracervical hysterectomy to control PPH. No maternal deaths occurred. Approximately 95% of the patients observed accepted all or some alternatives to blood transfusion. To treat JW patients in a safer manner, understanding their individual acceptance of alternatives to blood transfusion is important for the strategic use of such alternatives.