Gestação com Morte Encefálica Materna, aspectos éticos e manejo clínico: uma revisão integrativa

Abstract

Introduction: Brain Death (EM) is established by the definitive and irreversible loss of brain functions and by the cessation of cortical and brainstem activities due to a known and proven cause. The causes that lead the individual to brain death are diverse and are characterized by a complex process that causes several complications to the patient. The occurrence of brain death in a woman during pregnancy is a rare and peculiar circumstance, since it involves at least three lives: the mother, the fetus and potential hormone receptors. Objective: To seek to present cases of pregnant women diagnosed with brain death and the occurrence of this event over the years. Methodology: This is an integrative literature review with its six stages, carried out in the VHL, MEDLINE/PubMed, SCOPUS and EMBASE databases with the Health Sciences Descriptors (DeCS): "Pregnancy", "Brain Death", “Fetal Viability”, using “AND” and “OR” as search strategies. Inclusion criteria: Spanish, Portuguese and English languages published between 2005 and 2022, available in full, that met the proposed objective. Results: Six articles were selected, five in English and one in Portuguese. The approach found in all of them was resolved for the ethical and legal issues involving somatic support in pregnant women with brain death, aiming at the continuity of the pregnancy in the face of fetal viability. Final considerations: The literature demonstrates that there is still not enough evidence to provide experienced data for physicians and families for them to consider the treatment of a pregnancy with maternal brain death, although few studies demonstrate a successful result. Thus, maternal brain death is a rare and complex event that requires monitoring by a qualified multidisciplinary team.