Anemia in a Jehovah's Witness can be a challenging situation for the general obstetrician and gynecologist. With today's multicultural society, this issue is not as uncommon as previously thought. The following article reviews the alternatives to heterologous blood transfusion available to those patients who will not accept blood. A review of perioperative management is discussed, including cell salvage systems, normovolemic hemodilution, and controlled hypotensive anesthesia. Strategies for pre- and postoperative management are also presented. These include iron, erythropoietin, and nutrition. There are many options available, so management can be tailored to each specific situation. (C) 2000 Elsevier Science Inc.
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