International Journal of Hematology

, Volume 108, Issue 4, pp 432–437 | Cite as

Obstetric outcomes and acceptance of alternative therapies to blood transfusion by Jehovah’s Witnesses in Japan: a single-center study

  • Mie Tanaka
  • Shinya Matsuzaki
  • Masayuki Endo
  • Aiko Kakigano
  • Kazuya Mimura
  • Tsuyoshi Takiuchi
  • Tatsuya Miyake
  • Takuji Tomimatsu
  • Yutaka Ueda
  • Tadashi Kimura
Original Article


We sought to investigate obstetric outcomes and acceptance rates for blood products or types of autotransfusion by Jehovah’s Witnesses (JWs) at a single institution in Japan. We retrospectively reviewed cases of 84 pregnant JW patients and 95 deliveries from April 2001 to August 2017. We examined the acceptance rates of blood transfusions, blood products, and autotransfusion types in patients who experienced postpartum hemorrhage (PPH), and investigated estimated hemorrhage volume at delivery and PPH treatments. Of the 84 JW patients, none accepted blood transfusion; however, 75 patients (89.3%) accepted blood products, 57 (67.9%) accepted autotransfusion using intraoperative cell salvage, and four (4.8%) refused all alternatives to blood transfusion. Furthermore, PPH > 1000 mL occurred in 18 of the 95 (18.9%) deliveries. Of these 18 patients, four (22.2%) required blood products and three (16.7%) required supracervical hysterectomy to control PPH. No maternal deaths occurred. Approximately 95% of the patients observed accepted all or some alternatives to blood transfusion. To treat JW patients in a safer manner, understanding their individual acceptance of alternatives to blood transfusion is important for the strategic use of such alternatives.


Jehovah’s Witnesses Blood products Autotransfusion Obstetric outcomes Cell salvage 



The authors thank H. Abe and K. Sakiyama for their administrative assistance in preparing this manuscript.

Author contributions

MT, SM, and EM made substantial contributions to the conception and design of this manuscript, collected the clinical data, and drafted as well as revised the manuscript. KM, TTu, TTa, and TK helped in drafting the manuscript and responded to the submission requirements. TK conceived and generally supervised this study, and gave final approval for the publication of this manuscript. All the authors have read and approved the final manuscript.


There is no source of financial support or funding.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest or relevant financial relationships related to this study.


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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Mie Tanaka
    • 1
  • Shinya Matsuzaki
    • 1
  • Masayuki Endo
    • 1
  • Aiko Kakigano
    • 1
  • Kazuya Mimura
    • 1
  • Tsuyoshi Takiuchi
    • 1
  • Tatsuya Miyake
    • 1
  • Takuji Tomimatsu
    • 1
  • Yutaka Ueda
    • 1
  • Tadashi Kimura
    • 1
  1. 1.Department of Obstetrics and GynecologyOsaka University Graduate School of MedicineSuitaJapan

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