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8 - A case report of a placenta previa in a Jehovas witness patient
Melahat Dönmez, Alev Atış, Günseli Özdemir, Savaş Özdemir, Özlem Oruç, Selahattin Mısırlıoğlu
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 1927Jehovahs witnesses is a religion group which has a lot of member in the world who dont accept the transfusion of blood and blood products because of their belief thus there is a difficulty in this patients treatment. In this case, we discussed a placenta previa case belongs to Jehovahs 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 cant 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.
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