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一名怀孕13周的妇女因动脉瘤破裂导致脑死亡的处理

The Management of a Thirteen Weeks Pregnant Woman Rendered Brain-Dead Following a Ruptured Aneurysm.

作者信息

Pikto-Pietkiewicz Iwona, Okniński Antoni, Wójtowicz Rafał, Wójtowicz Marlena

机构信息

Central Clinical Hospital of the MSWiA. Clinical Department of Intensive Care and Anaesthesiology. Warsaw, Poland.

出版信息

J Crit Care Med (Targu Mures). 2019 Aug 9;5(3):111-114. doi: 10.2478/jccm-2019-0015. eCollection 2019 Jul.

DOI:10.2478/jccm-2019-0015
PMID:31431925
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6698076/
Abstract

INTRODUCTION

The current lack of clear guidelines on how to manage cases of brain-dead pregnant patients makes this topic controversial and extremely difficult to deal with for both medical and ethical reasons. This report deals with such a situation.

CASE PRESENTATION

A twenty-seven years old woman, thirteen weeks pregnant, with a ruptured brain aneurysm was admitted to an Intensive Care Unit. She presented with loss of all brain functions, but somatic support was sustained to enable the delivery of her baby.

CONCLUSION

The case report gives a detailed account of the management of the mother before the successful delivery of her baby. It indicates the need for ongoing contributions to the debate on this delicate subject area to establish guidelines on how to manage brain-dead pregnant patients.

摘要

引言

目前缺乏关于如何处理脑死亡孕妇病例的明确指南,这使得该话题颇具争议,并且由于医学和伦理原因极难处理。本报告探讨了这样一种情况。

病例介绍

一名27岁、怀孕13周的女性因脑动脉瘤破裂被收入重症监护病房。她已丧失所有脑功能,但仍维持躯体支持以确保其胎儿能够出生。

结论

该病例报告详细描述了在成功分娩前对这位母亲的处理过程。这表明需要继续为这一微妙领域的辩论做出贡献,以制定关于如何处理脑死亡孕妇的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c50/6698076/31b89995d586/jccm-05-111-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c50/6698076/31b89995d586/jccm-05-111-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c50/6698076/31b89995d586/jccm-05-111-g001.jpg

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本文引用的文献

1
Live or Let Die?: Fine Margins Between Life and Death in a Brain-Dead Pregnancy.
Med Law Rev. 2017 Nov 1;25(4):628-653. doi: 10.1093/medlaw/fwx026.
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Pregnancy and Brain Death: Lack of Guidance in U.S. Hospital Policies.怀孕与脑死亡:美国医院政策中缺乏相关指导
Am J Perinatol. 2016 Dec;33(14):1382-1387. doi: 10.1055/s-0036-1582445. Epub 2016 May 9.
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Continuation of pregnancy in a woman with critical brain injury.重度脑损伤女性的妊娠延续情况。
Anaesthesiol Intensive Ther. 2015;47(1):40-4. doi: 10.5603/AIT.2015.0005.
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A brain-dead pregnant woman with prolonged somatic support and successful neonatal outcome: A grand rounds case with a detailed review of literature and ethical considerations.一名接受长期躯体支持且新生儿结局成功的脑死亡孕妇:一个大查房病例,并对文献和伦理考量进行详细回顾
Int J Crit Illn Inj Sci. 2013 Jul;3(3):220-4. doi: 10.4103/2229-5151.119205.
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Neurology. 2010 Jun 8;74(23):1911-8. doi: 10.1212/WNL.0b013e3181e242a8.
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The prolongation of somatic support in a pregnant woman with brain-death: a case report.脑死亡孕妇的躯体支持延长:一例报告。
Reprod Health. 2006 Apr 27;3:3. doi: 10.1186/1742-4755-3-3.
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Irreversible maternal brain injury during pregnancy: a case report and review of the literature.
Obstet Gynecol Surv. 2000 Nov;55(11):708-14. doi: 10.1097/00006254-200011000-00023.