Download PDF
Am J Perinatol 1997; 14(7): 431-434
DOI: 10.1055/s-2007-994175
ORIGINAL ARTICLE

© 1997 by Thieme Medical Publishers, Inc.

Brain Death During Pregnancy: Tocolytic Therapy and Aggressive Maternal Support on Behalf of the Fetus

Val A. Catanzarite1 , David C. Willms2 , Kalman E. Holdy3 , Steve E. Gardner4 , Diane M. Ludwig5 , Larry M. Cousins1
  • 1Maternal-Fetal Medicine, Sharp Memorial Hospital, San Diego, California
  • 2Pulmonary/Critical Care Medicine, Sharp Memorial Hospital, San Diego, California
  • 3Endocrinology/Clinical Nutrition, Sharp Memorial Hospital, San Diego, California
  • 4Infectious Disease, Sharp Memorial Hospital, San Diego, California
  • 5Neonatology, Sharp Memorial Hospital, San Diego, California
Further Information

Publication History

Publication Date:
04 March 2008 (online)

Also available at
    Permissions and Reprints

ABSTRACT

We report a case of maternal brain death at 25 weeks gestation in which aggressive maternal hemodynamic, respiratory, and metabolic support and tocolytic drug therapy resulted in prolongation of pregnancy for 25 days. The indication for delivery was torulopsis giabrata amnionitis, which may have occurred due to transmembrane or transplacental route. The baby was treated for fungal sepsis, and did well. Premature labor may occur spontaneously after maternal brain death, and may be precipitated by infection or by maternal drug therapy. The myriad of hemodynamic and endocrine issues associated with maternal brain death complicate the choice of tocolytic drugs, but this case illustrates that uterine activity can be successfully blocked, potentially diminishing risks to the newborn, following the tragedy of maternal brain death during pregnancy.

Keywords

Brain death - pregnancy - preterm labor - tocolysis - adult respiratory distress syndrome