title: Presentation of cauda equina syndrome during labour.
abstract: Lumbar disc herniations are rare in pregnancy, with an incidence of 1:10,000. Less than 2% of these herniations result in cauda equina syndrome (CES). Diagnosing CES in pregnant patients can be difficult because changes in bladder and bowel habits are common in normal pregnancies. We present the case of a 29-year-old woman, with a history of lumbar radiculopathy, who presented at 39 weeks gestation with severe lower back and bilateral lower limb radiculopathy. Symptoms of CES began to develop only after the onset of labour. Diagnostic MRI was obtained following delivery and the patient was treated by microdiscectomy. Following surgery, bladder and bowel function began to normalise and at 3 months follow-up, she had made a full recovery. To the best of our knowledge, CES has never been reported to present during labour. This case highlights the diagnostic dilemma and need for a high index of suspicion.
authors.affiliation: Peninsula College of Medicine and Dentistry, Exeter, Devon, UK Exeter Spine Unit, Exeter, Devon, UK.
authors.forename: Conor Stephen
authors.initials: CS
authors.lastname: Jones
authors.affiliation: Peninsula College of Medicine and Dentistry, Exeter, Devon, UK Exeter Spine Unit, Exeter, Devon, UK.
authors.forename: Salil
authors.initials: S
authors.lastname: Patel
authors.affiliation: Exeter Spine Unit, Exeter, Devon, UK.
authors.forename: William
authors.initials: W
authors.lastname: Griffiths-Jones
authors.affiliation: Exeter Spine Unit, Exeter, Devon, UK.
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Stokes
mesh_terms: D000328:Adult; D002585:Cesarean Section; D017586:Diskectomy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000601:surgery; D011128:Polyradiculopathy / Q000175:diagnosis* / Q000601:surgery; D011247:Pregnancy