title: [Paraplegia and pregnancy].
abstract: OBJECTIVE
  To describe the characteristics of the management of pregnancy and child birth in women with spinal cord injury.
  
  
  METHODS
  Retrospective cohort study including paraplegics patients with motor deficit (whatever the etiology) who gave birth at the University Hospital of Toulouse between March 2003 and March 2014 (11 years). Monitoring and outcome of pregnancy were studied.
  
  
  RESULTS
  Seventeen deliveries (15 patients) were performed on a total of 46,888 in the studied period (prevalence=0.4‰). All patients had urinary tract infections: lower urinary tract (100%), recurrent cystitis (75%), pyelonephritis (31.3%). One patient (6.3%) presented dysautonomia during pregnancy. The cesarean rate was 47% (the indication was in any case an obstetrical reason). Among vaginal deliveries, four (44%) required an instrumental extraction. Epidural analgesia was the method of choice in the absence of contraindication.
  
  
  CONCLUSIONS
  Pregnancy associated with spinal cord injury requires a multidisciplinary approach. Autonomic hyperreflexia syndrome must be known and can be avoided by epidural analgesia in early labor. Vaginal delivery should be the rule.
authors.affiliation: Pôle de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Guerby
authors.affiliation: Pôle de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
authors.forename: F
authors.initials: F
authors.lastname: Vidal
authors.affiliation: Pôle d'anesthésie réanimation, hôpital Paule-de-Viguier, CHU de Toulouse, 31059 Toulouse, France.
authors.forename: F
authors.initials: F
authors.lastname: Bayoumeu
authors.affiliation: Pôle de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France; Université de Toulouse III, UMR1027, 31073 Toulouse, France; Inserm, UMR1027, 31073 Toulouse, France. Electronic address: olivier.parant@wanadoo.fr.
authors.forename: O
authors.initials: O
authors.lastname: Parant
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000628:therapy; D010264:Paraplegia / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Accouchement; Analgésie péridurale; Autonomic hyperreflexia; Delivery; Dysautonomie; Epidural analgesia; Grossesse; Paraplégie; Pregnancy; Spinal cord injury