Traumatic brain injury in pregnancy

Area of Science:

• Neuroscience
• Obstetrics & Gynecology
• Trauma Surgery

Background:

• Trauma is the leading cause of nonobstetric maternal mortality.
• Up to 8% of pregnancies are affected by trauma.
• Pregnant patients with traumatic brain injury (TBI) represent a vulnerable group with complex management needs.

Purpose of the Study:

• To review the complexities of managing traumatic brain injury (TBI) in pregnant patients.
• To highlight special considerations unique to this patient population.
• To summarize current expert opinion on the safety and efficacy of TBI management during pregnancy.

Main Methods:

• Review of existing literature, including case reports, series, and retrospective analyses.
• Synthesis of expert opinion regarding management strategies.
• Identification of specific challenges and exceptions in TBI treatment during pregnancy.

Main Results:

• Management of TBI in pregnancy involves unique considerations: altered maternal physiology, teratogenicity of treatments, fetal monitoring, Rh status, placental abruption, and preterm labor.
• Evidence is limited, primarily from case reports and retrospective studies.
• Standard TBI therapies are generally considered safe and effective in pregnancy, with some exceptions.

Conclusions:

• Despite limited evidence, standard TBI management is largely safe in pregnant patients.
• Further research is crucial to develop evidence-based guidelines for TBI management in pregnancy.
• Specialized protocols are needed to address the unique challenges of TBI in pregnant individuals.