Utilizing acute normovolemic hemodilution for blood conservation in myomectomy for Jehovah's Witnesses: A case report

Myomectomy for Jehovah's Witnesses presents a unique challenge because of their religious beliefs against blood transfusions. In this case report, we describe the successful management of a Jehovah's Witness patient with 22-week-sized uterine fibroids complicated by menorrhagia, emphasizing a multidisciplinary approach to blood conservation while respecting the patient's faith. She had a presenting hematocrit of 38%, which dropped to 33% just before surgery and subsequently had acute normovolemic hemodilution (ANH) along with meticulous surgical techniques, resulting in minimal blood loss and avoidance of allogeneic blood transfusions. She had good postoperative recovery and was discharged with hematocrit of 34%. This approach highlights the importance of understanding and accommodating patients' religious beliefs in surgical practice. Furthermore, it underscores the effectiveness of ANH as a viable alternative for blood conservation in high-risk surgical procedures.