Treatment of a Pregnant Patient in a Persistent Vegetative State

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.