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Table 1 An overview of the reported cases of extended maternal somatic support after brain death (BD) including neonatal outcomes*

From: One life ends, another begins: Management of a brain-dead pregnant mother-A systematic review-

Study Year/
country 		Age of mother (yr) Cause
of
BD 		Gestational age
at BD
(wk) 		Duration of life support (days) Maternal
medical
complications 		Indication
for
delivery 		Gestational age
at delivery
(wk) 		Mode
of
delivery 		Neonatal
outcome 		Organ
procurement 		Transplant
outcome
Dillon et al. [48] 1982/
USA 		24 Meningitis 23 24 Thermovariability,
DI 		Fetal distress 26 C/S Female, 930 gr,
Apgar 8/8, IRDS 		No -
Heikkinen et al. [49] 1985/
Finland 		31 ICH
SAH 		21 71 Thermovariability, pneumonia, hypotension, DI, bacteremia, panhypopituitarism Maternal
blood pressure fluctuation 		31 C/S Male, 1600 gr,
Apgar 6/7,
IRDS
Normal at 8 mo. 		No -
Field et al.
[14] 		1988/
USA 		27 CNS mass 22 63 Thermovariability, hypotension, panhypopituitarism, DI, ARDS, UTI, bacteremia Septicemia,
Growth retardation 		31 C/S Male, 1440 gr
Apgar 8/8,
IRDS,
normal at 18 mo. 		No -
Bernstein et al. [33] 1989/
USA 		30 Traumatic brain injury 15 107 Thermovariability, panhypopituitarism, pneumonia,
DI 		Suspicious for
fetal distress 		32 C/S Male, 1555 gr
Apgar 6/9,
Mild hyperbilirubinemia, Normal at 11 mo. 		No -
Antonini et al.
[50] 		1992/
Italy 		25 ICH 15 49 Panhypopituitarism,
Pneumonia
UTI,
Hemodynamic instability
Hyperglycemia
anemia 		Maternal death due to progressive hypotension Not applicable Not
applicable 		Intrauterine death No -
Nettina et al. [51] 1993/
USA 		31 ICH 27 44 hypothermia; hypotension; decubitus ulcer,
DI, pneumonia 		Maternal hypotension 33 C/S Male, 2083 gr
Apgar 9 		Yes N.A.
Anstotz
[52] 		1993/
Germany 		18 Accident 13 38 Severe infection Not applicable Not applicable Not
applicable 		Spontaneous abortion
at 19 weeks
(autopsy refused) 		No -
Beguin
[53] 		1993/
Switzerland 		20 ICH 20 3 No complication Not applicable Not applicable Not applicable Intrauterine death Yes N.A.
Wuermeling
[54] 		1994/
Germany 		18 Traffic accident 14 N.A infection N.A. N.A. N.A. Intrauterine death N.A. -
Iriye et al.
[55] 		1995/
USA 		35 ICH
after cocaine 		30 2 hypotension Maternal
blood pressure fluctuation 		30 C/S Male, 1610gr,
Apgar 7/8 		No -
Vives et al.
[56] 		1995/
Spain 		25 Meningitis 27 1,5 Hypotension,
sepsis,
DIC,
cardiac arrhythmia 		Maternal hypotension 27 C/S Male, 1150 gr,
Apgars 7/10,
IRDS,
normal at 14 mo. 		No -
Catanzarite et al. [32] 1997/
USA 		25 ICH 25 25 Hypotension, ARDS, DI, panhypopituitarism, pneumonia, Fetal distress 28 C/S Male, 1315 gr
Apgar 3/7
fungemia 		No -
Lewis et al.
[42] 		1997/
USA 		20 SAH 25 54 Hypotension, DI
bacteremia, 		Sufficient fetal
lung maturity 		32 C/S Not available Yes No complication after 1 year
Suddaby et al.
[2] 		1998/
USA 		Range from
15 to 45 (11 cases) 		5 cases:
ICH
1 case: Hematoma
1 case: Aneurysm
1 case:
Amniotic embolus
1 case:
Glioblastoma
1 case:
Cardiac arrest
1 case:
Gunshot 		Range from
2 to 40 		N.A Hypotension
DI
Anemia
Hypernatremia
Hyperglycemia
Hypocalcemia
hyperchloremia 		N.A N.A N.A N.A In five mothers Of 25 donated organs (5 heart, 5 liver,
10 kidney,
5 pancreas), only one liver and one pancreas graft lost.
Spike
[57] 		1999/
USA 		20 ICH 16 100 Panhypopituitarism, DI, Thermovariability
Hypotension 		Unusual pattern of the placenta in ultrasound 31 C/S Male, 1440gr
Apgar 8/8 		No -
Beca et al.
[58] 		1999/
Chile 		26 ICH 17 5 Hemodynamic instability
Fiber 		Maternal death due to resistance
hypotension 		Not applicable Not applicable Intrauterine death No -
Lane et al.
[59] 		2004/
Ireland 		26 Cerebral venous sinus thrombosis 13 8 DI,
pneumonia,
Hyper- and hyponatraemia 		Not applicable Not applicable Not applicable Intrauterine death
at 14 weeks 		Yes N.A.
Hussein et al.
[60] 		2006/
UK 		33 ICH 26 14 Hypertension, bradycardia,
Chest infection,
Hyperglycemia,
serum cortisol reduced 		Progressive oligohydraminos 28 C/S Male, 1285 gr,
breathing difficulties
Normal at 24 mo. 		No -
Souza et al.
[61] 		2006/
Brazil 		40 ICH 25 25 Panhypopituitarism, hyperglycemia DI, hypotension, bradycardia, hypothermia, pneumonia, Progressive oligohydraminos,
brain sparring 		29 C/S Male, 815 gr
Apgars:9/10
Normal at 3 mo. 		Yes N.A.
Mejia et al.
[62] 		2008/
Argentina 		29 ICH 17 56 DI
Panhypopituitarism,
Pneumonia
UTI,
Hemodynamic instability 		Maternal hypotension
&
Cardiac arrest 		25 C/S 450 gr
Premature Birth complication, Candida infection
Died at day 30 		No -
  1. *ICH, intracranial hemorrhage; SAH, subarachnoid hemorrhage; DI, diabetes insipidus; ARDS, acute respiratory distress syndrome; UTI, urinary tract infection; C/S, cesarean section; IRDS, infant respiratory distress syndrome; N.A: not available.
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