Karla Perez was 22 weeks pregnant when she suffered a massive brain hemorrage. Her state worsened to the point of clinical brain death — but a determined medical team managed to maintain the pregnancy so her son could survive.
On Feb. 8, Perez – who was pregnant with her second baby – came down with a headache so extreme that she fell unconscious at her home in Waterloo, Nebraska. She was taken to Methodist Women's Hospital, where doctors declared Perez clinically brain-dead. Her baby was safe — but not ready for delivery.
"It was then that we had decisions to make," said Dr. Andrew Robertson of the hospital's Perinatal Center in a statement. "Karla's baby was fine, but its gestational age was too young to consider delivery. That's when the team and Karla's family agreed to attempt to provide somatic support and maintain Karla's pregnancy until her baby reached a viable gestational age."
At 22 weeks, the baby did not have properly developed organs for surviving outside his mother's womb. That was when the medical team at the Methodist Health System, at the request of Perez's family, decided to attempt something they had never done before — keep an unborn baby alive as the mother's life was ebbing away.
The goal was to help the baby reach a minimum gestational age of 24 weeks under close supervision by Dr. Robertson and the perinatal team, with a target delivery date of 32 weeks. On April 4, however, doctors found Perez's condition was worsening and decided to deliver her baby via C-section. Two weeks short of their target, baby Angel was born, weighing two pounds and 12.6 ounces. His mother died two days later.
"There is nothing in the books about how to provide medical care in this situation," said Dr. Todd Lovgren, a maternal-fetal medicine specialist. "That's why our team approach was so important. We needed everyone on board with what we were trying to accomplish."
Only 33 other women since 1982 have been recorded to be brain-dead and kept alive on life support to deliver their babies. Perez was the first since 1992, according to the Methodist Health System.
Perez was kept alive for nearly eight weeks before she passed away. Although her baby needed a breathing tube in the delivery room, is now in a stable condition.
"Angel's condition remains very stable," said Dr. Brady Kerr from the neonatal intensive care unit of the Methodist Women's Hospital. "He has no severe complications. At this time he is still in an incubator and has a feeding tube — he is not yet feeding by mouth. It's hard for us to know the long-term outcome due to the rarity of this situation, but we are cautiously optimistic."
Perez's brain death was confirmed on April 6. On April 9, her heart, liver and kidneys were donated to individuals in need.
"She left me two little seeds and part of her and of course she gave life to three more people, so I'm proud as can be," said Berta Perez, Karla's mother.
