Pregnancy and autonomic hyperreflexia in patients with spinal cord lesions.
Symptoms of autonomic hyperreflexia in patients with complete and incomplete paraplegia above D 7 can be caused by almost any stimulus in the abdominal area or in the lower extremities, specifically during parturition by the uterine contractions. The symptoms vary from pilo-erection and outbreaks of sweating to serious blood pressure crises and cerebrovascular accidents. Epidural anaesthesia and general anaesthesia are effective as therapy and also as prophylaxis. Frequent complications are anemia and urinary tract infections. Changes in bladder function as a result of pregnancy and childbirth were observed. Paraplegic expectant mothers experience premature labour pains more frequently than do others, and this implies the necessity for earlier clinical surveillance up to the time of delivery. The secondary uterine inertia frequently requires an operative termination of the birth. The perception of labour pains is clearly possible also with lesions above D 10.
Wanner
M B
MB
Swiss Paraplegic Centre, Basel.
Rageth
C J
CJ
Zäch
G A
GA
D000328:Adult; D000773:Anesthesia, Obstetrical; D001342:Autonomic Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000628:therapy; D010146:Pain / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D011256:Pregnancy Outcome; D012021:Reflex, Abnormal / Q000209:etiology* / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications*