KIE: The authors are physicians affiliated with the State University of New York at Buffalo and the Children's Hospital of Buffalo. They describe the clinical management of two brain-dead pregnant women and suggest guidelines to help physicians decide whether to treat such women. Based on the dramatically increasing chances for fetal survival from the 24th to the 27th weeks of gestation, they recommend vigorous life support during this period to permit fetal viability and prognosis to be assessed. Fetuses of 28 weeks should be delivered by cesarean section as soon as practicable after confirmation of maternal brain death.