Guidelines for supporting a pregnant patient with brain death: A case discussion and literature review

Abstract

Brain death implies irreversible cessation of the brainstem function. While it is generally considered unethical and futile to continue to support vital organs once a diagnosis of brain death has been made, patients who are both pregnant and brain dead complicate this issue because the appropriateness of continuing maternal somatic support to prolong gestation to delivery is still debated. This article will review the literature, and open up dialogue, about the need for guidelines and recommendations in anesthesia care, including the ethics, legality, and cost of supporting the mother’s life to save an unborn child, when somatically supporting pregnant patients who are brain dead, are in a persistent vegetative state (PVS), or are in a coma due to irreversible brain injury. Making a case for or against supporting such patients is outside the scope of this paper. This review finds that the need for guidelines to assist healthcare professionals in providing care to somatically supported mother is necessary.