American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 1987
Case ReportsInsufficient transplacental digoxin transfer in severe hydrops fetalis.
A case of severe nonimmune hydrops fetalis caused by supraventricular tachycardia is presented. Maternal treatment with digoxin and the subsequent addition of verapamil and propranolol failed to be effective. Simultaneous measurement of maternal serum and cord blood digoxin levels showed insufficient transplacental digoxin transfer. Other modalities of treatment are discussed.
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Am. J. Obstet. Gynecol. · Nov 1987
The pregnant brain dead and the fetus: must we always try to wrest life from death?
This article deals with the ever more timely and often vexing topic of maintaining a brain-dead mother as an incubator for her developing offspring. It explores the issue by: (1) reviewing the history of the problem and the "state of the art" today, (2) examining the moral problem of using brain-dead persons as incubators for potential or actual others, (3) searching for moral differences between maternal death early or late in pregnancy, and (4) presenting a possible resolution in such tragic cases. It concludes that (1) a moral necessity to deliver viable infants from brain-dead mothers exists; (2) the farther from viability brain death occurs, the more maintaining the mother as an incubator resembles experimental therapy with its imperative for careful, informed consent; (3) experimental therapy not being morally necessary, its proceeding under these tragic circumstances should invoke community support for the next of kin in dealing with the immediate and long-term costs; (4) all ethical problems proceed in a context to which the moral actors must be sensitive and one that alters the conclusions made.