title: Treatment of a Pregnant Patient in a Persistent Vegetative State.
abstract: Brain injury leading to a persistent vegetative state during pregnancy involves difficult medical and ethical decisions.
  
  
  
  A 21-year-old multigravid woman entered a persistent vegetative state at 20 1/7 weeks of gestation after cardiac arrest with postanoxic brain injury from a suspected drug overdose. The clinical disciplines responsible for her case formed a collaborative care plan involving ventilator, nutrition, and medication support of the mother and regular fetal monitoring and ultrasound testing. A planned delivery by cesarean at term resulted in a good neonatal outcome.
  
  
  
  There is no standardized management plan for obstetric care in a persistent vegetative state. This case illustrates a successful multidisciplinary approach that may be useful as a template in similar situations.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, the Department of Education, and the Department of Respiratory Care, Lehigh Valley Health Network, Allentown, Pennsylvania.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Romagano
authors.forename: William E
authors.initials: WE
authors.lastname: Scorza
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Lammers
authors.forename: Carole
authors.initials: C
authors.lastname: Dorr
authors.forename: John C
authors.initials: JC
authors.lastname: Smulian
mesh_terms: D002585:Cesarean Section; D062787:Drug Overdose / Q000150:complications; D017809:Fatal Outcome; D005260:Female; D005323:Fetal Monitoring; D006323:Heart Arrest / Q000150:complications; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications; D007231:Infant, Newborn; D050498:Live Birth; D018529:Nutritional Support; D010348:Patient Care Team; D018458:Persistent Vegetative State / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000628:therapy*; D012121:Respiration, Artificial; D016216:Ultrasonography, Prenatal; D055815:Young Adult