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Brainstem death in the pregnant patient is a tragic but fortunately rare event that involves complex medical, ethical, and legal issues. Prolongation of maternal somatic function constitutes experimental care where the physician must consult case reports and reviews and extrapolate from experiences in sustaining organ function after brain death to facilitate organ donation. Nutritional support should be initiated early and preferably via the enteral route. Special attention should be paid to the management of gastroesophageal reflux in the context of pregnancy and of the reduced motility of the gastrointestinal tract in brain-dead patients. Three main sources of sepsis may complicate prolonged somatic support, including ventilator associated pneumonia, urinary tract infections from dwelling catheters, and infection of intravascular catheters. The goal of extended maternal somatic support is to attempt to facilitate fetal maturation in order to deliver a healthy, viable infant.
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