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Delivery of a Healthy Baby from a Brain-Dead Woman After 117 Days of Somatic Support: A Case Report

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GÁL Roman ZIMOVÁ Iveta ANTONI Helena MINARČÍKOVÁ Petra VENTRUBA Pavel HRUBAN Lukáš HRDÝ Ondřej

Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj American Journal of Case Reports
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://europepmc.org/article/med/34001845
Doi http://dx.doi.org/10.12659/AJCR.930926
Klíčová slova Brain Death; Case Reports; Critical Care; Delivery; Obstetric; Life Support Care; Pregnancy
Popis Objective: Rare disease Background: The care and management of brain-dead pregnant women is surrounded by legal and ethical controversies. Gestational age is directly proportional to newborn survival. We report a case of a brain-dead pregnant woman at the 16th week of gestation and the successful delivery of a healthy child after 117 days of maternal somatic support. Case Report: A 27-year-old pregnant woman at 16 weeks' gestation with large intracerebral hematoma after rupture of an arteriovenous malformation was admitted to our intensive care unit. Signs of brain death developed early, and the woman was confirmed to be brain dead after day 6 of hospitalization. The decision-making process regarding course of medical treatment was complex and accompanied by uncertainties arising from the absence of a legal, ethical, and professional framework. A complex multidisciplinary approach was followed. The main aim was to maintain the brain-dead woman's homeostasis to allow for proper development of the fetus. Monitoring of fetal growth was considered the best endpoint, and satisfactory fetus development was achieved. A healthy child was delivered with a birth weight of 2140 g. Her Apgar score was 10/10/10 at 1, 5, and 10 minutes, respectively, and favorable outcomes were observed at a 1-year follow-up. Conclusions: Brain death during pregnancy is an extremely rare but increasingly common condition. Guidelines for care management are lacking, and reporting these cases may help establish medical treatment in future cases. We show that somatic support of the body of a brain-dead pregnant woman for an extended period of time can lead to successful delivery of a healthy child.

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