Meralgia paresthetica in the parturient.
Meralgia paresthetica is a common sensory mononeuropathy of the lateral femoral cutaneous nerve which occurs in pregnancy as well as in many other conditions. The most likely etiology in pregnancy is entrapment of the nerve as it passes around the anterior superior iliac spine or through the inguinal ligament. Onset of symptoms, most commonly numbness on the anterolateral thigh but possibly including burning, tingling, and other paresthesias, can occur at any time during pregnancy or immediately after labor and delivery. Symptoms, which are almost always self-limited, can be disturbing to the parturient and may interfere with normal daily activities. If the physician is not familiar with this disorder and the involved anatomy, the search for a diagnosis can result in unneccessarily expensive tests and consultations. A careful neurologic examination is usually all that is necessary for diagnosis. When the diagnosis of meralgia paresthetica is made prior to childbirth, this should not contraindicate the use of regional anesthesia, if necessary, for labor and delivery. The mother should be reassured that the symptoms usually resolve following delivery. Conservative therapy such as minimizing periods of standing, eliminating tight clothing and using oral analgesics may contribute to recovery. As a last resort surgical therapy has been shown to be effective in some cases.
Van Diver
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Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Camann
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