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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
DOI: 10.1055/s-0041-1733862
Review Article | Artigo de Revisão

Traumatic Brain Injury in Pregnancy

Traumatismo cranioencefálico na gravidez
Letícia Adrielle dos Santos 
1   Department of Neurosurgery, Universidade Federal do Sergipe, Aracaju, SE, Brazil
,
Carlos Umberto Pereira 
2   Department of Neurosurgery, Hospital de Urgência do Sergipe, Aracaju, SE, Brazil
,
Maycon Cristian Gomes de Paula 
3   Department of Neurosurgery, Universidade do Vale do Sapucaí, Pouso Alegre, MG, Brazil
,
Gabriela Ferreira Kalkmann 
4   Department of Neurosurgery, Universidade Federal do Paraná, Curitiba, PR, Brazil
,
Nicollas Nunes Rabelo 
5   Department of Neurosurgery, Centro Universitário UniAtenas, Paracatu, MG, Brazil
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Abstract

Objective The present paper aims to provide a review on the main complications involving traumatic brain injury (TBI) during pregnancy and on the vegetative state after TBI.

Methods A systematic review was performed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria checklist.

Results Seven studies were included, of which four were case reports, one was a follow-up, one was a comparative study, and one was a literature review.

Discussion Presence of neurological deficits such as hemiparesis, neonatal seizures, cerebral palsy, hemorrhage or hydrocephalus was observed in children of mothers who suffered trauma during pregnancy. The prolongation of a pregnancy in these victims, even in brain death, is within the reach of current medicine. Ethical issues must be considered when deciding to prolong a pregnancy of a woman in brain death.

Conclusion For the evaluation of pregnant women with TBI, there is a protocol that can be followed in the emergency care service. The cases reported in the literature suggest that there is no clear limit to restrict support to a pregnant patient in a vegetative state. Further studies should be done to elucidate this matter.

Resumo

Objetivo O presente artigo buscou revisar as principais complicações envolvendo lesão cerebral traumática durante a gravidez e sobre estado vegetativo após esse trauma.

Métodos Uma revisão sistemática foi realizada de acordo com o checklist dos critérios Principais itens para relatar Revisões sistemáticas e Metanálises (PRISMA, na sigla em inglês).

Resultados Sete estudos foram incluídos, dos quais quatro eram relatos de caso, um era um acompanhamento, um era um estudo comparativo, e um era uma revisão de literatura.

Discussão Presença de déficit neurológico como hemiparesias, convulsões neonatais, paralisia cerebral, hemorragia e hidrocefalia foram observadas em crianças cuja mãe sofreu trauma durante a gravidez. O prolongamento da gravidez nessas vítimas, mesmo nos casos de morte cerebral, está ao alcance da medicina atual. Dilemas éticos devem ser considerados na decisão de prolongar a gravidez em mulheres com trauma cerebral.

Conclusão Para avaliação de grávidas com trauma cerebral, existe um protocolo que pode ser seguido em serviços de emergência. Os casos relatados na literatura sugerem que não há um limite claro para restringir o suporte a uma paciente grávida em estado vegetativo. Mais estudos devem ser realizados para elucidar a questão.

Keywords

traumatic brain injury - pregnancy - management - developmental disabilities - persistent vegetative state

Palavras-chave

traumatismo cranioencefálico - gravidez - gestão - deficiências de desenvolvimento - estado vegetativo persistente


Publication History

Received: 01 August 2020

Accepted: 09 March 2021

Article published online:
07 February 2022

© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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