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By Elizabeth Chuck
The disquieting case of a woman from Arizona who, although she was in vegetative state for more than a decade, is not the first of their kind. Experts reported on NBC News.
The woman, 29, arrived at Hacienda HealthCare in Phoenix in December after an almost drowning break. The authorities do not know who impregnated them and have launched a sexual assault investigation in search of their rapist.
The case sounds like a 1
Jeffrey Spike, an adjunct faculty member of the University of Virginia's School of Medicine, Center for Biomedical Ethics and Humanities, served as the Ethics Advisor for the University of Virginia Hospital treating the New York woman and talking with her parents about whether they had the Wanted to end pregnancy. They decided against it, and in March 1996 the woman gave birth to a premature but healthy boy, raised by his maternal grandmother.
In patients in vegetative states, Spike said, "cognitively, all human qualities are gone, but biologically, everything is pretty normal," so a pregnancy can happen.
"Whatever caused her daughter to be in a vegetative state was such a terrible tragedy, and then to discover that she was raped and then having to make that very difficult big decision, It was really difficult, "Spike said.
Other women were in vegetative states or brain dead during pregnancy, but their brain function was compromised during pregnancy – not before, Dr. Deborah Feldman, Director of the Department of Maternal-Fetal Medicine at Hartford Health Care in Connecticut.
In 2000, Feldman wrote a paper on maternal brain injury in which 11 cases of irreversible brain injury in pregnant women were studied. 10 out of 11 babies had survived. The cases included mothers who were brain-destroying in the brain and in a sustained vegetative state.
The Difference Between a Vegetative State and a "Brain Dead"
Cases of brain-dead women artificially kept alive during pregnancy have made headlines, including Marlise Munoz, a Texan woman Munoz was eventually divorced from life after a lawsuit and the fetus, which was claimed to have abnormalities on ultrasound, died.
Dr. Rezvan Ahmadi, a senior neurosurgeon at Heidelberg University Hospital in Germany, brain-dead pregnant mothers has examined and said that patients are treated very differently in vegetative states.
"Brain death in Germany will be defined as the death of man, and any guideline concerns saving the baby's life and also organs for To save organ transplants, "she said." Vegetative people live, therefore we can not do anything to end her life. So there's no question that everything needs to be done to save a baby's life and a mother's life. "
In a vegetative state Patients can breathe and regulate their heartbeats themselves, but receive intravenous nutrition and hydration, and show no signs of awareness.
"You will see that eye opening is happening … but the other parts have no brain capabilities in terms of understanding the language, expressing the faces of people, things of that nature," said Dr Gregory O & # 39; Shanick, Medical Director of the Brain Injury Association of America. "There is no kind of purposeful behavior they show, so you can see random movements, they make a sound and they can move once or twice but it is not reproducible or consistent. "
No doubt in my mind, personally and medically, that this was an attack."
# 39; Shanick said there is "no way" that someone in a vegetative state could agree to a sexual encounter, "I have no doubt, personally and medically, that this was an attack."
Pregnancy in patients with brain injury
The brain injury that caused the vegetative state, added O & # 39; Shanick, would probably not contribute to physical challenges during pregnancy.
"If there was no other type of physical injury, fracture, or other type of spinal cord injury, everything else would probably be intact," he said. "The main problem was that she still has her period, and probably the answer is yes."
And a lack of prenatal care, though important, could not have affected the baby, said Mother-Fetus Director Feldman. Possible problems with a patient in a vegetative state would mainly focus on lack of exercise. These include limiting the growth of the fetus, poor placenta function, increased blood pressure or gestational diabetes.
"It's hard to be sure, but if there are no significant birth defects and if the baby has grown normally, there is an expectation that the baby will thrive and be normal," she said.
How could nobody have known? All the experts said, although it was surprising that hacienda's employees did not seem to realize that the patient was pregnant, this could go unnoticed depending on the size of the woman's midsection.
A doctor who had examined her eight months earlier in April The born press reported on Thursday, though it was perhaps too early.
"I would expect someone who bathed her to notice this, but I do not know how much she was worried," Feldman said. "They would expect her belly to grow over nine months, but sometimes things like that will be different in different patients."
If she felt anything else in her body, it would have been impossible to communicate these changes to her caretakers, said O & # 39; Shanick of the Brain Injury Association of America.
"Could they have noticed anything in other secondary changes in the size of their breasts and other things, but that's not something you generally track," he said. "You do not think in these terms, I can assure you that from now on people will think in these terms."