One life ends, another begins: Management of a brain-dead pregnant mother-A systematic review-

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• 作者：Majid Esmaeilzadeh (1)
  Christine Dictus (2)
  Elham Kayvanpour (2)
  Farbod Sedaghat-Hamedani (1)
  Michael Eichbaum (3)
  Stefan Hofer (4)
  Guido Engelmann (5)
  Hamidreza Fonouni (1)
  Mohammad Golriz (1)
  Jan Schmidt (1)
  Andreas Unterberg (2)
  Arianeb Mehrabi (1)
  Rezvan Ahmadi (2)
  
• 刊名：BMC Medicine
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：8
• 期：1
• 全文大小：780KB
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  63. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1741-7015/8/74/prepub
  
• 作者单位：Majid Esmaeilzadeh (1)
  Christine Dictus (2)
  Elham Kayvanpour (2)
  Farbod Sedaghat-Hamedani (1)
  Michael Eichbaum (3)
  Stefan Hofer (4)
  Guido Engelmann (5)
  Hamidreza Fonouni (1)
  Mohammad Golriz (1)
  Jan Schmidt (1)
  Andreas Unterberg (2)
  Arianeb Mehrabi (1)
  Rezvan Ahmadi (2)
  
  1. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
  2. Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
  3. Departments of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
  4. Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany
  5. Department of Pediatrics, University of Heidelberg, Heidelberg, Germany
  

文摘

Background An accident or a catastrophic disease may occasionally lead to brain death (BD) during pregnancy. Management of brain-dead pregnant patients needs to follow special strategies to support the mother in a way that she can deliver a viable and healthy child and, whenever possible, also be an organ donor. This review discusses the management of brain-dead mothers and gives an overview of recommendations concerning the organ supporting therapy. Methods To obtain information on brain-dead pregnant women, we performed a systematic review of Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). The collected data included the age of the mother, the cause of brain death, maternal medical complications, gestational age at BD, duration of extended life support, gestational age at delivery, indication of delivery, neonatal outcome, organ donation of the mothers and patient and graft outcome. Results In our search of the literature, we found 30 cases reported between1982 and 2010. A nontraumatic brain injury was the cause of BD in 26 of 30 mothers. The maternal mean age at the time of BD was 26.5 years. The mean gestational age at the time of BD and the mean gestational age at delivery were 22 and 29.5 weeks, respectively. Twelve viable infants were born and survived the neonatal period. Conclusion The management of a brain-dead pregnant woman requires a multidisciplinary team which should follow available standards, guidelines and recommendations both for a nontraumatic therapy of the fetus and for an organ-preserving treatment of the potential donor.