Introduction: Due to strong religious faith and beliefs against blood transfusions, Jehovah’s Witness patients often pose tight spot for obstetrician-gynecologists. Myelosuppressive effects of chemotherapy in gynecology-oncology settings are additional source of worry.
Case Presentation: A 25-year-old P0+1 Nigerian woman presented with subcostal pains, dyspnea and cough productive of bloody sputum of one month duration. There was no vaginal bleeding. She had spontaneous miscarriage and evacuation of retained products of conception twice at another health facility with histology confirming choriocarcinoma. She was anemic and had a Durable- Power-of-Attorney card forbidding blood transfusion. She received Iron dextran and erythropoietin prior to each of three courses of olychemotherapy. Beta-Human Chorionic Gonadotrophin returned to normal 456 days later and had normal pregnancy sixteen months later.
Conclusion: This first reported case of gestational choriocarcinoma in a Jehovah’s Witness who survived without obstetrics sequalae is illustrative of such managed in resource-poor setting while maintaining patient autonomy.
Published on: Nov 9, 2015 Pages: 10-12