Maternal mortality and serious maternal morbidity in Jehovah’s witnesses in the Netherlands

Wolfswinkel, Marlies E van; Zwart, Joost J.; Schutte, Joke M.; Duvekot, Johannes J.; Pel, Maria; Roosmalen, Jos van

doi:10.1111/j.1471-0528.2009.02191.x

Cited by 54 publications

(28 citation statements)

References 13 publications

(29 reference statements)

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“…This high rate of morbidity is consistent with other studies [12, 26]. The rate of morbidity may be higher in low-income settings where not all treatment modalities are available or for Jehovah’s witnesses who refuse blood products [3, 15, 33]. …”

Section: Discussionsupporting

confidence: 89%

Incidence, management and outcome of women requiring massive transfusion after childbirth in the Netherlands: secondary analysis of a nationwide cohort study between 2004 and 2006

Ramler

Akker

Henriquez

et al. 2017

BMC Pregnancy Childbirth

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BackgroundPostpartum hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Few population-based studies have examined the epidemiology of massive transfusion for postpartum hemorrhage. The aim of this study was to determine the incidence, management, and outcomes of women with postpartum hemorrhage who required massive transfusion in the Netherlands between 2004 and 2006.MethodsData for all women from a gestational age of 20 weeks onwards who had postpartum hemorrhage requiring eight or more red blood cell concentrates were obtained from a nationwide population-based cohort study including all 98 hospitals with a maternity unit in the Netherlands.ResultsThree hundred twenty-seven women who had postpartum hemorrhage requiring massive transfusion were identified (massive transfusion rate 91 per 100,000 deliveries (95% confidence interval: 81–101)). The median blood loss was 4500 mL (interquartile range 3250–6000 mL) and the median number of red blood cell concentrates transfused was 11 units (interquartile range 9–16 units). Among women receiving massive transfusion, the most common cause of hemorrhage was uterine atony. Eighty-three women (25%) underwent hysterectomy, 227 (69%) were admitted to an intensive care unit, and three women died (case fatality rate 0,9%).ConclusionThe number of women in the Netherlands who had postpartum hemorrhage treated with massive transfusion was relatively high compared to other comparable settings. Evidence-based uniform management guidelines are necessary.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1384-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 89%

Incidence, management and outcome of women requiring massive transfusion after childbirth in the Netherlands: secondary analysis of a nationwide cohort study between 2004 and 2006

Ramler

Akker

Henriquez

et al. 2017

BMC Pregnancy Childbirth

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“…For example, refusal of blood products is common in patients who are Jehovah's Witnesses. This subset of patients has between a 44-fold to 130fold higher risk of maternal mortality from obstetric hemorrhage because of refusal of blood products (94,95). Because this population may accept some blood products, a predelivery directive that can be used in the event of a severe postpartum hemorrhage can be discussed with the patient during the prenatal period (18,96).…”

Section: What Is the Management Approach For Secondary Or Delayed Posmentioning

confidence: 99%

Tranexamic acid as adjuvant treatment for postpartum hemorrhage: a systematic review protocol

Fahrenholtz

Bonanno²,

Martin

2019

JBI Database of Systematic Reviews and Implementation Reports

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Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). In the United States, the rate of postpartum hemorrhage increased 26% between 1994 and 2006 primarily because of increased rates of atony (3). In contrast, maternal mortality from postpartum obstetric hemorrhage has decreased since the late 1980s and accounted for slightly more than 10% of maternal mortalities (approximately 1.7 deaths per 100,000 live births) in 2009 (2, 4). This observed decrease in mortality is associated with increasing rates of transfusion and peripartum hysterectomy (2)(3)(4).The purpose of this Practice Bulletin is to discuss the risk factors for postpartum hemorrhage as well as its evaluation, prevention, and management. In addition, this document will encourage obstetrician-gynecologists and other obstetric care providers to play key roles in implementing standardized bundles of care (eg, policies, guidelines, and algorithms) for the management of postpartum hemorrhage.

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“…Des études observationnelles américaine, anglaise et hollandaise ont établi que le refus de recourir à la transfusion augmente le risque de décès maternel en situation d'hémorragie (NP4) [7][8][9]. La prise en charge de ces patientes doit être formalisée une fois que l'obstétricien et l'anesthésiste ont rencontré la patiente, ainsi que son compagnon et éventuellement d'autres membres de l'entourage (avis d'experts) [2].…”

Section: Situations Particulièresunclassified

Prise en charge anténatale des patientes à risque d’hémorragie du post-partum (hors anomalies de l’insertion placentaire)

Fournet-Fayard

Lebreton

Ruivard

et al. 2014

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Maternal mortality and serious maternal morbidity in Jehovah’s witnesses in the Netherlands

Cited by 54 publications

References 13 publications

Incidence, management and outcome of women requiring massive transfusion after childbirth in the Netherlands: secondary analysis of a nationwide cohort study between 2004 and 2006

Incidence, management and outcome of women requiring massive transfusion after childbirth in the Netherlands: secondary analysis of a nationwide cohort study between 2004 and 2006

Tranexamic acid as adjuvant treatment for postpartum hemorrhage: a systematic review protocol

Prise en charge anténatale des patientes à risque d’hémorragie du post-partum (hors anomalies de l’insertion placentaire)

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