Background: Critical brain injury can lead to brain death, which is medically and legally considered the death of an individual. Further therapy is discontinued, unless organ donation is possible or brain death occurs in a pregnant woman. Case report: A 30-year old woman at 22 weeks gestation developed a subarachnoid haemorrhage from a ruptured cerebral artery aneurysm. The patient was admitted to the Intensive Care Unit in critical condition. On treatment day 3, the symptoms of brain death occurred. Due to possible complications, the apnoea test and instrumental examinations were not performed. Therapy maintaining vital functions was carried out in order to sustain the pregnancy. The patient was ventilated, received cardiac-supportive drugs, hormone replacement therapy, enteral and parenteral feedings and systemic infections were treated as well. At the beginning of the 27 th week of gestation, massive bleeding from the airways developed. A Caesarean section was performed, and a female neonate was born, birth weight 680 g, the Apgar scores 4, 6 and 6 at 1 st , 5 th and 10 th minute, respectively. After 3.5 months, the baby was discharged from the Neonatal Intensive Care Unit. Her development at the age of 8 months is normal. Conclusions: The case described and similar cases reported in the literature demonstrate that the maternal brain death is an interdisciplinary medical challenge. Thanks to intensive care techniques, maternal somatic functions can be maintained, and a healthy child can be delivered.
Only a small number of studies draw attention to the relationship between body image after pregnancy and during lactation with the decision to undertake and continue breastfeeding. Body image is a complex mental construct, which consists of: cognitive, emotional and behavioural components, and which is subject to change during the life of the woman. Pregnancy, childbirth and lactation affect the physicality of women, which is also reflected in the way of defining their body image. Dissatisfaction with own body can affect the decision to breastfeed or cause discomfort during breastfeeding. At the same time, undertaking breastfeeding can, through the hormones secreted at the time, positively influence the assessment of the woman’s body before and during pregnancy. The discovery of this relationship, and in the future indicating the precise correlation phenomena, could have a practical use in working with patients whether to breastfeed. By noticing and identifying an early onset of irregularities in the forming body image of a pregnant women, healthcare professionals can support those in need to build a real body image and positive attitude towards occurring changes and thus increase their comfort. Recognising and understanding the obstacles women experience on the road to breastfeeding, educators and professionals can create programs which consider a more complex, psycho-physical dimension of breastfeeding.
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