title: Maternal brain death: medical, ethical and legal issues.
abstract: METHODS
  We present the case of a pregnant woman who experienced a cerebral venous sinus thrombosis resulting in brain death at 13 weeks gestation. We discuss the management of the mother and foetus following this tragic event. We also discuss the complex medical, legal and ethical issues that arose following maternal brain death. The central question is whether continuing maternal organ supportive measures in an attempt to prolong gestation to attain foetal viability is appropriate, or whether it constitutes futile care.
  
  
  CONCLUSIONS
  Successful maintenance of maternal brain somatic function to facilitate foetal maturation in utero has been reported. While the gestational age of the foetus is central to resolving this issue, there is no clear upper physiological limit to the prolongation of somatic function following brain death. Furthermore, medical experience regarding prolonged somatic support is limited. Finally, the legal rights conferred on the foetus may vary significantly depending on the jurisdiction in which the maternal brain death occurs and may have important implications.
  
  
  CONCLUSIONS
  A consensus building approach, involving the family, is essential to resolving these potentially conflicting issues.
authors.affiliation: Department of Anaesthesia and Intensive Care, University College Hospital, Galway, Ireland.
authors.forename: Alan
authors.initials: A
authors.lastname: Lane
authors.forename: Andrew
authors.initials: A
authors.lastname: Westbrook
authors.forename: Deirdre
authors.initials: D
authors.lastname: Grady
authors.forename: Rory
authors.initials: R
authors.lastname: O'Connor
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Counihan
authors.forename: Brian
authors.initials: B
authors.lastname: Marsh
authors.forename: John G
authors.initials: JG
authors.lastname: Laffey
mesh_terms: D000328:Adult; D001926:Brain Death / Q000331:legislation & jurisprudence* / Q000378:metabolism; D004989:Ethics; D005260:Female; D005333:Fetus; D006801:Humans; D008429:Maternal Welfare / Q000941:ethics*; D011247:Pregnancy; D012851:Sinus Thrombosis, Intracranial / Q000150:complications