Evidence map›Paper›PMID 39266866›Full record

ArticleNeurocritical care2025

A Survey on the Management of Patients with Severe Traumatic Brain Injury During Pregnancy: The MAMA Study.

Edoardo Picetti, Monica S Vavilala, Raul Coimbra, Rafael Badenes, Marta V Antonini, Goran Augustin, Rocco Armonda, Walter L Biffl, Simone Di Filippo, Daniel A Godoy and 7 more

Abstract read
PubMed Publisher
In one paragraph

Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Traumatic brain injury in obstetric patients: challenges and management strategiesRevista colombiana de obstetricia y ginecologia · 2025
    Review
  4. Machine Learning Approaches to Prognostication in Traumatic Brain Injury.Current neurology and neuroscience reports · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Edoardo PicettiDepartment of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy. epicetti@ao.pr.it.ORCID 0000-0003-0316-1451
Monica S VavilalaDepartment of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Raul CoimbraDivision of Trauma and Acute Care Surgery and Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, Moreno Valley, CA, USA.
Rafael BadenesDepartment of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Clínic Universitari de Valencia, University of Valencia, Valencia, Spain.
Marta V AntoniniIntensive Care Unit, Bufalini Hospital, AUSL della Romagna, Cesena, Italy.
Goran AugustinDepartment of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
Rocco ArmondaDepartment of Neurosurgery, Georgetown University School of Medicine and MedStar Washington Hospital Center, Washington, DC, USA.
Walter L BifflDivision of Trauma and Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
Simone Di FilippoDepartment of Biotechnology and Sciences of Life, Anesthesia and Intensive Care, ASST Sette Laghi, University of Insubria, Varese, Italy.
Daniel A GodoyNeurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina.
Brian GordonDepartment of Obstetrics and Gynecology, Los Angeles County University of Southern California Medical Center, Los Angeles, USA.
Matthew J MartinDivision of Trauma and Acute Care Surgery, Department of Surgery, Scripps Mercy Hospital, San Diego, CA, USA.
Kevin G PhungDepartment of Clinical Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
Fabio S TacconeDepartment of Intensive Care, Hopital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium.
Gianluigi ZonaNeurosurgery, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Martino, Genoa, Italy.
Fausto CatenaEmergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy.
Chiara RobbaDepartment of Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Policlinico San Martino, Genoa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTrauma, including traumatic brain injury (TBI), is the leading cause of nonobstetric maternal mortality during pregnancy. Few data are available regarding the optimal management of pregnant patients with TBI, leading to a lack of dedicated guidelines. We performed an international survey to examine the management of severe TBI in pregnant patients, focusing on monitoring, therapy, and intensive care practices.

methodsThis survey, endorsed by the World Society of Emergency Surgery, was composed of a questionnaire with 79 items divided into four sections: (1) general information (items 1-7), (2) management of the maternal-fetal unit (items 8-43), (3) management of intracranial hypertension (items 44-76), and (4) specific considerations (items 77-79).

resultsOne hundred and twenty-two physicians from 110 centers in 35 countries responded. The main findings related to TBI care in pregnant patients included the following: (1) a lack of availability of a specific TBI protocol in pregnancy; (2) an increase in the utilization of magnetic resonance imaging as the primary neuroimaging tool; (3) higher hemoglobin thresholds for transfusion; and (4) a lower utilization of therapeutic hypothermia, neuromuscular blocking agents, and barbiturate coma. We also report large variability in the timing of cesarean section in pregnant patients with TBI (≥ 23 weeks of gestation) needing an emergency craniotomy (simultaneously 23% vs. later cesarean section 50.8%).

conclusionsGreat variability in the management of pregnant patients with severe TBI was identified worldwide from the results of our survey. These findings, highlighting the lack of robust evidence on this topic, will be helpful to stimulate future investigations and to promote educational efforts on this difficult scenario.

Indexed as

Brain Injuries, TraumaticCritical CareIntracranial HypertensionPractice Patterns, Physicians'Pregnancy ComplicationsAdultFemaleHealth Care SurveysHumansHypothermia, InducedPregnancyManagementPregnancyTraumatic brain injury

Identifiers

PMID39266866

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.