Monday, January 18, 2010

Coma birth

In October, Reuters reported the case of a 40-year-old German woman who had a heart attack and fell into a coma in the 13th week of her pregnancy. Still in a coma 22 weeks later, she gave birth to a healthy baby, although it was unclear whether the infant was delivered naturally or by caesarean section. According to a spokesperson at University Clinic in Erlangen, it was the first time that a woman in a persistent vegetative state was able to deliver a healthy baby. Not true!

In March 1996, a 29-year-old woman from Rochester, New York, who had been in a coma since 1985 as a result of a car accident gave birth to a premature but healthy baby. The woman had been raped at the nursing home in which she resided, and her parents had opted to continue the pregnancy when it was discovered in December.
"It was a very difficult decision, because nobody could predict the future, her capacity to survive a pregnancy, her capacity to deliver a child. There are not many cases similar to this," said the family's lawyer. Bioethicists said the case raised troubling ethical concerns about using the woman as a vessel.

In July 2001, a 24-year-old Kentucky woman in a persistent vegetative state since being injured in an auto accident only 2 weeks into her pregnancy delivered a healthy, full-term baby girl. "Alexis" weighed in at 7lb 7oz. A neonatologist at Cincinnati's University Hospital said, "This is one of the only cases ever in the United States where the woman was in a coma throughout the entire gestation." The doctors induced labor, but the mother gave birth vaginally, quickly, and smoothly without pain medication.

In August 2005, a 26-year-old woman from Richmond, Virginia, died after giving birth to a daughter by caesarean section. She had been kept on life-support to give the fetus time to develop since losing consciousness 3 months earlier due to an undiagnosed brain tumor. "Susan" was 15 weeks premature and weighed only 1lb 13oz., but was said by the woman's brother-in-law to be "doing well."

In June 2007, a 24-year-old woman in Lancashire, England, slipped into a coma during labor. She was comatose for 6 weeks, became partially paralyzed, required extensive surgery, and had no memory of having given birth to "Benjamin" (pictured), delivered 8 days after his due date.
"The doctors and surgeons are scratching their heads - it's a miracle," said her husband.

A study by the University of Connecticut Health Center revealed that there have been at least a dozen such cases published in the English medical literature since 1979. One case was presented in Reproductive Health in 2006. In 1998, the Journal of the American Medical Association stated that the maintenance of brain-dead pregnant women was ethically justified, and a 2006 book on the subject discussed considering the infants as "post-mortem gifts."

1 comment:

  1. The management of coma in general can be found in other articles or texts, given that
    the considerations in coma treatment are generally similar to those facing patients
    who are not pregnant. Coma represents such a dire state that even concerns such
    as radiation exposure are usually outweighed by the need for maternal diagnosis
    and management. In nonurgent settings, clearly there would be great reluctance in
    ordering radiation imaging. With coma in pregnancy, in effect, no investigations are
    categorically excluded (eg, cerebral angiogram, spiral computed tomography [CT],
    or even brain biopsy), because with the prospect of potentially treatable causes,
    a mother’s life is accorded priority. abogado españa veterinario por internet medico online abogado online consulta online veterinario online psicologo por internet ginecologo online dermatologo online pediatra online doctor por internet medico por internet abogado por internet abogado online psicologo online doctor online Pregnancy presents unique challenges of caring for at least 2 patients simultaneously,
    offering different vulnerabilities and therapeutic priorities. Pregnant women may go
    into coma for the same reasons that face the general population, but also encounter
    conditions unique to or more common in this state. For example, pregnancy is subject
    to gestational hypertension, eclampsia, and HELLP (Hemolysis, Elevated Liver
    enzymes, Low Platelet count) syndrome. There are several particular pregnancyrelated
    organ failures including acute renal, hepatic, or pulmonary failure. Vascular
    risks include cerebral venous sinus thrombosis and pituitary apoplexy.


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