Twins born to brain dead mother on a respirator for a month

By Dr. Ananya Mandal, MDApr 24 2012

Christine Bolden – a 26 year old woman was already brain dead from aneurysms, but doctors at a western Michigan hospital kept her on a respirator for a month to allow for the development of babies who were born prematurely at 25 weeks.

The Muskegon woman collapsed in a parking lot due to aneurysms on March 1 and was declared ‘brain dead’ five days later at the hospital next door, Spectrum Health Butterworth. Nicholas and Alexander Bolden weighed less than 2 pounds when they were born by caesarean section on April 5, and remain on ventilators at Helen DeVos Children's Hospital in Grand Rapids.

Bolden's family asked doctors “to drop everything we could to save these babies. It wasn't that difficult a call,” spokesman Bruce Rossman said. “It required a lot of evaluations and discussions among our staff. They had to at least get to 24 weeks before we could consider delivery.”

Dr. Cosmas Vandeven, who specializes in high-risk pregnancies at University of Michigan hospital, said Bolden's case is a “very exceptional scenario.” He said an important ethical issue in cases like these is whether a brain-dead woman would suffer by being kept on a respirator and undergoing a C-section. “Almost every parent would give their life for their child,” Vandeven said. “But you need to get truly independent opinions: Are we sure we're not causing harm to the mom?” He said 70 percent of babies born at 25 weeks survive, but the risk for long-term health problems is high. Rossman acknowledged that chronic conditions are possible even if the boys pull through. “We certainly hope they make it, but at this time they're too young to make a confident prognosis,” he said.

Bolden had two other children, an 11-year-old daughter and a 3-year-old son. Relatives said it was heart breaking to see her die, but a relief to see the twins survive.