Healthy baby delivered vaginally from a brain‐dead mother

Abstract

Case: A pregnant (20 gestational weeks) 32-year-old woman was found in cardiac arrest. Spontaneous circulation returned after 15 min. She became brain dead on the 13th hospital day. The patient was in stable circulatory condition under nasal desmopressin and 20-30 mg/day of hydrocortisone. On the 92nd hospital day at gestational week 33 + 3 days, natural labor began and a healthy 2,130-g girl (Apgar 6/8) was delivered vaginally with minimum assistance.Outcome: The baby was discharged 40 days after birth and followed up regularly. Conclusion: Brain death remains a hopeless condition for patients, but a brain-dead woman may still be able to naturally deliver a healthy baby.

Vaginal delivery in the 30+4 weeks of pregnancy and organ donation after brain death in early pregnancy

“…Interestingly, the present case is not the first to describe a spontaneous delivery after brain death with hypopituitarism,6 yet without organ donation.…”

“…Of note, in the cited case, confirmation of the brain death (by means of the standard apnoea test) was postponed to the postnatal period (98th hospital day). Interestingly, and unlike the accepted procedure in Germany, it was stated that subsequently “the mother was transferred to a local hospital and died approximately 1 year after brain death” 6. The latter description emphasises the heterogeneous handling of such challenging situations, as well as a differentiation between the concepts of ‘brain death’ versus ‘dying’.…”

Status of Baby Born to Brain-dead Mother: Ethical and Logical Issues

“…Nevertheless, a case report of a pregnant woman with an irreversible brain stem injury in which spontaneous vaginal birth took place can be found in literature. The child received 6 and 8 points on the Apgar scale and was discharged 40 days after birth (Kinoshita et al, 2015). Wood et al examined the correlation between the degree of disability in children and the week of gestation at which they were born (Wood et al, 2000).…”

Ethische, psychosoziale und rechtliche Aspekte der Behandlung hirntoter Schwangerer

“…tung ausgelegte Therapie begonnen, die formale Diagnostik und Feststellung jedoch erst postpartal durchgeführt[17]. Das Argument einer möglichen Fruchtschädigung durch die Diagnostik sollte aufgrund der zugelassenen Untersuchungsgänge obsolet sein (vgl.…”

“…Das Argument einer möglichen Fruchtschädigung durch die Diagnostik sollte aufgrund der zugelassenen Untersuchungsgänge obsolet sein (vgl. BÄK-Richtlinie[3]), wird jedoch im internationalen Schrifttum immer wieder angeführt[17,18]. Inwieweit hierbei betreuungsrechtliche Unsicherheiten (s. Abschnitt "Betreuungsrechtliche Überlegungen") eine Rolle spielten, ist unklar.…”