MANAGEMENT OF SEVERE TRAUMATIC BRAIN INJURY IN PREGNANCY

Giat Seng Kho1,3 Jafri Malin Abdullah1,2

Affiliation: Department of Neurosciences1, Center for Neuroscience Service and
Research2, Kubang Kerian, 16150 Kelantan, Malaysia; Department of
Neurosurgery, Sarawak General Hospital3, Jalan Hospital, 93586 Kuching
Sarawak, Malaysia.

ABSTRACT

Traumic brain injury during pregnancy is the leading cause of non- obstetric
maternal mortality, with 20% of maternal death directly attributable to injuries.
Motor vehicle accident, domestic or intimate partner violence, were the most
common non lethal injuries in 1 in every 12 pregnant women.
Traumatic brain injury in pregnancy is a multidisiplinary teams approach. The
management of a pregnant trauma patient warrants consideration of several
issues specific to pregnancy such as alterations in maternal physiology and
anatomy.
Maternal cardiac arrest with amniotic fluid embolism, intact neonatal survival
was linked to timing of cesarean after maternal cardiac arrest. Sixty-seven
percent of neonates had intact survival if delivered before 15 minutes, whereas
only 40% had intact survival when delivery was delayed between 16 and 25
minutes after maternal arrest.
Traumatic brain injury during pregnancy, whether minor or severe, is
associated with unfavorable maternal outcomes. Injuries considered minor for
the general population are not minor for pregnant women. Therefore, these
patients should be intensively monitored.