BMJ Case Reports 2018; doi:10.1136/bcr-2018-225260
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Management of placenta percreta in a Jehovah’s Witness patient

  1. Marilyn Huang2
  1. 1 University of Miami Miller School of Medicine, Miami, FL, USA
  2. 2 Obstetrics & Gynecology, Division of Gynecologic Oncology, University of Miami Miller School of Medicine, Miami, Florida, USA
  1. Correspondence to Dr Marilyn Huang, m.huang{at}
  • Accepted 29 May 2018
  • Published 11 June 2018


Placenta percreta is increasing in incidence and is associated with the risk of life-threatening haemorrhage. Patients who do not accept blood products present a unique challenge to obstetrician-gynaecologists. In this case report, we present the case of a 42-year-old pregnant Jehovah’s Witness with a complete placenta previa and confirmed percreta at 26 weeks’ gestation. Due to her religious beliefs against the use of blood products, she was managed with a stepwise surgical approach which involved caesarean delivery with internal iliac (hypogastric) artery ligation, weekly methotrexate and delayed hysterectomy 6 weeks later. Non-traditional, alternative approaches to the management of abnormal placentation in patients declining blood products warrant exploration.


  • Contributors AJW participated in the data collection, analysis, literature review and writing of this manuscript. MS participated in patient management, literature review and editing of this manuscript. MH oversaw all activities, coordinating patient management, literature review and editing of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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