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Trauma craneoencefálico en paciente obstétrica: desafíos y estrategias de manejo.

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Title: Trauma craneoencefálico en paciente obstétrica: desafíos y estrategias de manejo.
Alternate Title: Traumatic brain injury in obstetric patients: challenges and management strategies.
Authors: Andrés Mora-Arteaga, Javier1 jamora@husi.org.co, Camilo Reyes, Diego2,3, Saa González, Daniela4, Rivera Tobar, Isabella5
Source: Revista Colombiana de Obstetricia y Ginecologia. jul-sep2025, Vol. 76 Issue 3, p1-16. 16p.
Subjects: BRAIN injuries, PREGNANCY, NEUROPHYSIOLOGIC monitoring, OBSTETRICIANS, ETHICAL problems, INTRACRANIAL hypertension, THERAPEUTICS, FETAL physiology
Abstract (English): Objective: To provide a conceptual framework for the management of traumatic brain injury (TBI) in pregnant women, integrating pathophysiological foundations, available scientific evidence, and current clinical strategies to support decisionmaking. Materials and methods: Based on a hypothetical case that practically illustrates the topic, an explanatory document was developed using a structured narrative review. It describes the physiological changes of pregnancy relevant to TBI, the principles of initial resuscitation, the management of intracranial hypertension, the use of neuromonitoring, obstetric care, and the ethical implications associated with maternal death by neurologic criteria. Results: Pregnancy involves anatomical and functional adaptations that alter the maternal response to trauma. These modifications affect the airway, hemodynamics, oxygenation, and cerebral autoregulation, necessitating adjustments in clinical management. Key aspects include initial stabilization, control of intracranial hypertension, neuromonitoring, obstetric care, and ethical considerations in scenarios of maternal death by neurologic criteria. Conclusions: The management of TBI in pregnant patients is a clinical challenge that requires an understanding of maternal physiology and its impact on acute brain injury. Given the lack of specific guidelines and recommendations, those established for the general population should be applied with careful consideration of the physiological changes of pregnancy. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivo: ofrecer un marco conceptual para el abordaje del trauma craneoencefálico (TCE) en gestantes, integrando los fundamentos fisiopatológicos, la evidencia científica disponible y las estrategias clínicas actuales que apoyen la toma de decisiones. Materiales y métodos: a partir de un caso hipotético que ilustra de manera práctica el tema, se desarrolla un documento explicativo basado en una revisión narrativa estructurada. En él se describen los cambios fisiológicos del embarazo relevantes para el TCE, los principios de reanimación inicial, el manejo de la hipertensión intracraneal, el uso del neuromonitoreo, el abordaje obstétrico y las implicaciones éticas asociadas a la muerte materna por criterios neurológicos. Resultados: el embarazo conlleva adaptaciones anatómicas y funcionales que alteran la respuesta Trauma craneoencefálico en paciente obstétrica: desafíos y estrategias de manejo Traumatic brain injury in obstetric patients: challenges and management strategies Javier Andrés Mora-Arteaga1; Diego Camilo Reyes2,3; Daniela Saa González4; Isabella Rivera Tobar5 materna al trauma. Estas modificaciones impactan la vía aérea, la hemodinamia, la oxigenación y la autorregulación cerebral, lo que requiere ajustar el abordaje clínico. Se destacan aspectos clave como el manejo inicial, el control de la hipertensión intracraneal, la neuromonitorización, el cuidado obstétrico y las implicaciones éticas en escenarios de muerte materna por criterios neurológicos. Conclusiones: el manejo del TCE en gestantes es un desafío clínico que requiere conocer la fisiología materna y su impacto en la lesión cerebral aguda. Dada la falta de guías y recomendaciones específicas, se deben adoptar las recomendaciones de la población general teniendo presentes los cambios fisiológicos del embarazo. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Objective: To provide a conceptual framework for the management of traumatic brain injury (TBI) in pregnant women, integrating pathophysiological foundations, available scientific evidence, and current clinical strategies to support decisionmaking. Materials and methods: Based on a hypothetical case that practically illustrates the topic, an explanatory document was developed using a structured narrative review. It describes the physiological changes of pregnancy relevant to TBI, the principles of initial resuscitation, the management of intracranial hypertension, the use of neuromonitoring, obstetric care, and the ethical implications associated with maternal death by neurologic criteria. Results: Pregnancy involves anatomical and functional adaptations that alter the maternal response to trauma. These modifications affect the airway, hemodynamics, oxygenation, and cerebral autoregulation, necessitating adjustments in clinical management. Key aspects include initial stabilization, control of intracranial hypertension, neuromonitoring, obstetric care, and ethical considerations in scenarios of maternal death by neurologic criteria. Conclusions: The management of TBI in pregnant patients is a clinical challenge that requires an understanding of maternal physiology and its impact on acute brain injury. Given the lack of specific guidelines and recommendations, those established for the general population should be applied with careful consideration of the physiological changes of pregnancy. [ABSTRACT FROM AUTHOR]
ISSN:00347434
DOI:10.18597/rcog.4358