title: One life ends, another begins: Management of a brain-dead pregnant mother-A systematic review-.
abstract: BACKGROUND
  An accident or a catastrophic disease may occasionally lead to brain death (BD) during pregnancy. Management of brain-dead pregnant patients needs to follow special strategies to support the mother in a way that she can deliver a viable and healthy child and, whenever possible, also be an organ donor. This review discusses the management of brain-dead mothers and gives an overview of recommendations concerning the organ supporting therapy.
  
  
  METHODS
  To obtain information on brain-dead pregnant women, we performed a systematic review of Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). The collected data included the age of the mother, the cause of brain death, maternal medical complications, gestational age at BD, duration of extended life support, gestational age at delivery, indication of delivery, neonatal outcome, organ donation of the mothers and patient and graft outcome.
  
  
  RESULTS
  In our search of the literature, we found 30 cases reported between 1982 and 2010. A nontraumatic brain injury was the cause of BD in 26 of 30 mothers. The maternal mean age at the time of BD was 26.5 years. The mean gestational age at the time of BD and the mean gestational age at delivery were 22 and 29.5 weeks, respectively. Twelve viable infants were born and survived the neonatal period.
  
  
  CONCLUSIONS
  The management of a brain-dead pregnant woman requires a multidisciplinary team which should follow available standards, guidelines and recommendations both for a nontraumatic therapy of the fetus and for an organ-preserving treatment of the potential donor.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany.
authors.forename: Majid
authors.initials: M
authors.lastname: Esmaeilzadeh
authors.forename: Christine
authors.initials: C
authors.lastname: Dictus
authors.forename: Elham
authors.initials: E
authors.lastname: Kayvanpour
authors.forename: Farbod
authors.initials: F
authors.lastname: Sedaghat-Hamedani
authors.forename: Michael
authors.initials: M
authors.lastname: Eichbaum
authors.forename: Stefan
authors.initials: S
authors.lastname: Hofer
authors.forename: Guido
authors.initials: G
authors.lastname: Engelmann
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Fonouni
authors.forename: Mohammad
authors.initials: M
authors.lastname: Golriz
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.forename: Andreas
authors.initials: A
authors.lastname: Unterberg
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.forename: Rezvan
authors.initials: R
authors.lastname: Ahmadi
mesh_terms: D001926:Brain Death; D001930:Brain Injuries / Q000150:complications* / Q000401:mortality; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D019369:Life; D011247:Pregnancy; D011248:Pregnancy Complications; D009927:Tissue and Organ Procurement