| Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc |
| Journal website http://www.jcgo.org |
Case Report
Volume 3, Number 1, February 2014, pages 42-49
One Hundred and Fourteen Days of Somatic Support in a Severely Brain Injured Pregnant Woman: Case Report and Review of the Literature
Tables
| Form of unconsciousness | Self-awareness | Suffering | Motor function | Sleep-wake cycles | Respiratory function | EEG* activity | Cerebral metabolism | Life expectancy | Neurologic recovery |
|---|---|---|---|---|---|---|---|---|---|
| *EEG denotes electroencephalography. | |||||||||
| Coma | Absent | No | No purposeful movement | Absent | Depressed, variable | Polymorphic delta or theta | Reduced by 50% or more (variable) | Variable | Usually recovery, PVS or death |
| Persistent vegetative state | Absent | No | No purposeful movement | Intact | Normal | Polymorphic delta/theta sometimes slow alpha | Reduced by 50% or more | Usually 2 - 5 years | Nontraumatic: rare after 3 months, traumatic: rare after 12 months |
| Brain death | Absent | No | None or only reflex spinal movements | Absent | Absent | Electrocerebral silence | Absent | Death within 2 - 4 weeks | No recovery |
| Organ system | Measured parameter | Direction of change | Values in normal pregnancy |
|---|---|---|---|
| FRC: functional residual capacity; SVR: systemic vascular resistance; COP: capillary osmotic pressure; PCWP: pulmonary capillary wedge pressure; vWF: von Willebrand factor. | |||
| Respiratory | Minute ventilation | Increases 50% | |
| Oxygen consumption increases | Increases 20% | ||
| FRC | Decreases 20% | ||
| Arterial PCO2 | Decreases | ||
| Serum bicarbonate | Decreases | 28 - 32 mmHg | |
| Chest wall compliance | Decreases | 18 - 21 mEq/L | |
| Cardiovascular | Cardiac output | Increases 50% | 6.2 ± 1.0 L/min |
| Blood volume | Increases 30-50% | ||
| Heart rate | Increases by 15-20% | 83 ± 10 beats/min | |
| SVR | Decreases 20% | 1,210 ± 256 dynes/sec/ cm-5 | |
| COP | Increases 15% | 18 ± 1.5 mmHg | |
| PCWP | Decreases | 7.5 ± 1.8 mmHg | |
| Aortocaval compression | Increases | ||
| Hematologic | Clotting factors I, VII, VIII, IX, X, vWF | Increases | |
| Protein C and S | Decreases | ||
| Gastrointestinal | Motility | Decreases in both | |
| Lower esophageal sphincter | |||
| Renal | Compensated respiratory alkalosis | Increases in both | |
| Glomerular filtration rate | |||