Intra-uterine fetal brain death: report of two cases and review of the literature

Abstract

The fetal heart rate (FHR) variability is used as a parameter in evaluating fetal well-being. Persistent decreased or absent variability is considered a bad prognostic sign and usually prompts an emergency cesarean section. We present two cases of severely decreased FHR variability and emergency cesarean section in which the neonates were pronounced brain dead shortly after delivery. We believe that if intra-uterine brain death could be diagnosed on the basis of suspiciously persistent low or absent FHR variability, surgical procedures that endanger the health of the mother could be prevented. The possibility of intra-uterine brain death should be considered in all the cases of persistently low or absent FHR variability.