{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T21:12:18Z","timestamp":1771189938563,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,5,29]]},"abstract":"<jats:p>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\u2019s Witness with a complete placenta previa and confirmed percreta at 26\u2009weeks\u2019 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\u2009weeks later. Non-traditional, alternative approaches to the management of abnormal placentation in patients declining blood products warrant exploration.<\/jats:p>","DOI":"10.1136\/bcr-2018-225260","type":"journal-article","created":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T01:05:00Z","timestamp":1528765500000},"page":"bcr-2018-225260","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Management of placenta percreta in a Jehovah\u2019s Witness patient"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5959-3045","authenticated-orcid":false,"given":"Adriana J","family":"Wong","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine, Miami, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Schlumbrecht","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, Division of Gynecologic Oncology, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilyn","family":"Huang","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, Division of Gynecologic Oncology, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,11]]},"reference":[{"key":"2025082722484957000_2018.jun11_1.bcr-2018-225260.1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/j.ajog.2015.04.034","article-title":"Conservative management of morbidly adherent placenta: expert review","volume":"213","author":"Fox","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"2025082722484957000_2018.jun11_1.bcr-2018-225260.2","first-page":"66","article-title":"Urologic complications of placenta percreta invading the urinary bladder: a case report and review of the 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