Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK.
St. George's International School of Medicine, St. George's, Grenada.
Arch Gynecol Obstet. 2024 Feb;309(2):475-481. doi: 10.1007/s00404-023-06940-x. Epub 2023 Feb 3.
The aim of the study is to assess obstetric and fetal outcomes of Jehovah's Witnesses (JWs) mothers in an inner city teaching hospital, as well as to examine the acceptance rates of various blood fractions and blood transfusion alternatives.
Case series to evaluate the maternal and fetal outcomes of JWs over a nine period between 2013 and 2021.
There were 146 pregnancies extracted from our database, of which 10 were early pregnancy losses. Data from 136 deliveries > 24 weeks' gestation were assessed, with a mean maternal age and gestational age of 30.26 (± 5.4) years and 38.7 (± 5.3) weeks, respectively. 57% had normal vaginal deliveries, 8% had instrumental births and 35% had caesarean births. Mean estimated blood loss at caesarean was 575 (± 305.6) mls, while the overall mean estimated loss was 427.8 (± 299.8) mls. Cell salvage was performed in all caesarean sections but autologous transfusion was only necessary for 26%. Consultant presence was documented in 62% of caesarean births. The mean birthweight and 5-min Apgar scores were 3.31 (± 0.05) kg and 9.1 (± 0.09), respectively. There were no maternal deaths or admissions to the adult intensive care unit and the most serious complication was a uterine rupture following a trial of scar, after which the baby required cooling for hypoxic ischaemic encephalopathy.
Pregnant JWs received obstetric care led by senior clinicians, with optimisation of haematinics, minimizing of blood loss at delivery and access to technology such as cell salvage.
本研究旨在评估在一家市区教学医院中，作为耶和华见证人的母亲的产科和胎儿结局，以及检查各种血液成分和输血替代物的接受率。
这是一项病例系列研究，评估了 2013 年至 2021 年期间的 9 个时期内的耶和华见证人的母亲的母婴结局。
从我们的数据库中提取了 146 例妊娠，其中 10 例为早期妊娠丢失。评估了 136 例>24 周分娩的数据，产妇的平均年龄和妊娠年龄分别为 30.26（±5.4）岁和 38.7（±5.3）周。57%为正常阴道分娩，8%为器械分娩，35%为剖宫产。剖宫产术中平均估计出血量为 575（±305.6）毫升，而总平均估计出血量为 427.8（±299.8）毫升。所有剖宫产术中均进行了细胞回收，但仅 26%需要自体输血。记录了 62%的剖宫产术有顾问在场。平均出生体重和 5 分钟 Apgar 评分分别为 3.31（±0.05）kg 和 9.1（±0.09）。没有产妇死亡或入住成人重症监护病房，最严重的并发症是疤痕试产后子宫破裂，随后婴儿因缺氧缺血性脑病需要冷却。
接受妊娠的耶和华见证人由资深临床医生提供产科护理，优化血液成分，减少分娩时的出血量，并可使用细胞回收等技术。
