Pregnancy in a quadriplegic patient treated with continuous intrathecal baclofen infusion to manage her severe spasticity. Case report.
A report on pregnancy in a quadriplegic patient treated with a high dose of 1000 mcg/24 h continuous intrathecal baclofen infusion using an implanted drug delivery system (Synchromed, Medtronic, USA). Spasticity could be managed up to the 35th week of gestation. However, uterine contractions evoke enormous spastic symptoms which we, even with maximum values of the spasticity scales, could not classify. The recurrence of spasticity was associated with autonomic dysregulation. With continuous epidurally infused bupivacaine (11.25 mg/h) adequate relaxation could be reached and gestation was terminated by a primary caesarean section. A healthy girl was born (2040 g, Apgar 9 and 10).
Delhaas
E M
EM
Department of Anaesthesiology, Sophia Hospital, Zwolle, The Netherlands.
Verhagen
J
J
D000328:Adult; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use*; D002585:Cesarean Section; D004343:Drug Implants; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011782:Quadriplegia / Q000150:complications* / Q000188:drug therapy; D014590:Uterine Contraction / Q000502:physiology
D004343:Drug Implants; D001418:Baclofen