A case report of a placenta previa in a Jehova‘s witness patient

Introduction: The most frequent causes of perinatal and maternal mortality and morbidity is antepartum bleeding. Placenta previa is very important in antepartum bleeding. The incidence is 03-03 %. It can be total, partial, marginal or low segment placed placenta previa. Bleeding in placenta previa cases is an unpainful hemorrhage which is not seen until the 2.trimester.Death caused by placenta previa decreases with adequate blood transfusion caeserian/sectio which advised by Bill in 1927Jehovah’s witnesses is a religion group which has a lot of member in the world who don’t accept the transfusion of blood and blood products because of their belief thus there is a difficulty in this patient’s treatment. In this case, we discussed a placenta previa case belongs to Jehovah’s witnesses.
Case: 36 years old, according to the last menstrual bleeding 31-32 weeks pregnant women came to our clinic with vaginal bleeding complaint. MGS04 treatment was started as tocolysis, steroid was given for lung maturation, and followed for bleeding. After 3 weeks the Hgb level ped to 10,6gr/dl so iv Fe treatment was started. After 1 week, because of bleeding, patient was undergone to cesearianlsection. No complication was seen per or postoperatively. Baby was followed in newborn sendee for respiratuvar problems by CPAP.
Results: Hemostasis and surgical procedures (radical operations if needed) must be applied promptly in cases which transfusion can’t be performed. Also ivferrum therapy was prepared for probability of bleeding. In these patients iv ferrum therapy can be more effective over eritropoetin; because of the shorter affecting time. But in patients with severe anemia increase risk of post operative mortality and morbidity must be remembered.

Yahova þahidi inanýþýna sahip bir gebede plasenta previa olgusu

Antepartum kanamalar grubu içinde önemli bir grubu plasenta previa oluþturmaktadýr. Plasenta previa kanamasý 2. trimesterin sonuna veya daha sonrasýna kadar görülmeyen að¬rýsýz hemorajilerdir.Neyse ki baþlangýçtaki kanama nadiren öldürücü olacak miktardadýr. Yahova þahitleri, dünya üzerinde birçok üyesi bulunan dini bir grup olup, inanýþlarý gereði, kan ve kan ürünlerinin transfüzyonunu kabul etmezler. Bu olguda gebelikte anemisi olan Yahova þahidi inanýþýna sahip bir plasenta previa olgusunu ele aldýk. Otuzaltý taþýnda, son adet tarihine göre 31-32 gh gebe kliniðimize vajiýýal kanama þikayetiyle baþvurdu.Yapýlan ultrasonografi bulgularý 31 -32 gh, ASV: N, baþ geliþi, tekiz, FKA pozitif, plasenta previa parsiyalis ile uyumluydu. Takiplerde günlük 2-3 ped kanamasý olan hasta $ hafta takýp sonunda Hb: 10,6g/dl’ye düþmesi üzerine intravenöz Fe tedavisine baþlandý. Bir hafta tedavi sonunda hastanýn kanamasýnýn artmasý üzerine 34 haftada sezaryene (ds) alýndý. Introoperatifve postoperatif herhangi bir komplikasyon olmadý. Deðiþik nedenlerle kan transfüzyonun yapýlamadýðý hallerde hemostaza maksimum önem göstererek, gerektiðinde radikal cerrahi yaklaþýmý da içeren cerrahi teknikler acilen uygulanmalýdýr. Bu hastalarda eritropoetine göre, intravenöz Fe preparation daha hýzlý etki ettiðinden iyi bir alternatif olabilir.