Vaginal delivery in the 30+4 weeks of pregnancy and organ donation after brain death in early pregnancy.
Adult
Advance Directives
Brain Death
Counseling
Critical Care
Female
Fetal Viability
/ physiology
Humans
Life Support Care
/ ethics
Living Donors
/ ethics
Mothers
Patient Advocacy
/ ethics
Patient Rights
/ ethics
Pregnancy
Pregnancy Outcome
Prenatal Care
/ ethics
Tissue and Organ Procurement
/ ethics
adult intensive care
ethics
pregnancy
trauma
trauma CNS/PNS
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
30 Sep 2019
30 Sep 2019
Historique:
entrez:
2
10
2019
pubmed:
2
10
2019
medline:
29
2
2020
Statut:
epublish
Résumé
A 28-year-old woman suffered a traffic accident resulting in severe head injuries with deleterious prognosis. Diagnostics further revealed a hitherto unknown pregnancy, at suspected week 9. Based on the patient's wish to donate organs, brain death protocol confirmed irreversible loss of brain function. Yet, vital pregnancy rendered organ transplantation impossible. Multiple ethical and legal issues arose, from invalidation of established legal care after brain death to the delivery of a healthy child after trauma and long-term critical care. After medicolegal and ethical counselling, pregnancy was sustained, and the goal of organ donation postponed. Critical care focused on foetal homeostasis. At 30+4 weeks, a viable girl was born via assisted vaginal delivery. Postpartal organ donation resulted in heart, kidney and pancreas transplantation. The case emphasises the medical, legal and ethical challenges to combine two apparently diametrical goals: the successful full-term pregnancy and the fulfilment of a patient's wish to donate organs.
Identifiants
pubmed: 31570361
pii: 12/9/e231601
doi: 10.1136/bcr-2019-231601
pmc: PMC6768348
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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