title: Good prognosis of postpartum lower limb sensorimotor deficit: a combined clinical, electrophysiological, and radiological follow-up.
abstract: Postpartum lower limb motor and/or sensory deficit is an uncommon obstetrical complication. We aimed to identify its incidence, etiology, and precipitating factors, as well as the neurological prognosis by retrospectively analyzing the successive neurological evaluations, electrophysiological, and MRI data from all the consecutive patients with postpartum motor and/or sensory deficits of the lower limbs referred from the Lariboisière Obstetrical Department to the Lariboisière Neurophysiology Department, from January 2012 to June 2016, as well as data concerning labor and morphological characteristics of mother and baby. Thirteen patients (0.11% of the parturient women in the Lariboisière hospital) were included. Eight (62%) had lumbosacral plexopathy. Symptoms followed a first vaginal delivery in 10/13 patients (77%), in patients who were mostly overweight (mean patient BMI before pregnancy 25.6 ± 3.2 kg/m2). Labor duration was slightly longer than average (mean labor duration 8.9 ± 2.9 h). No other potentially precipitating factor was identified. Recovery was good in all patients, 7/11 (64%) made a rapid full recovery (mean recovery time 5 ± 2.5 weeks excluding one patient who had a normal neurological examination at 2 weeks but still complained of foot weakness that fully recovered in 1 year), and a minority (4/11, 36%) still complained of minor symptoms at time of follow-up, but showed marked improvement. New mothers presenting postpartum lower limb nerve injury should, therefore, be reassured.
authors.affiliation: Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Richard
authors.affiliation: Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Vellieux
authors.affiliation: Service de Gynécologie-Obstétrique, Néonatologie, AP-HP, Hôpital Lariboisière, 75475, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Abbou
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.|Service de Gynécologie-Obstétrique, Néonatologie, AP-HP, Hôpital Lariboisière, 75475, Paris, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Benifla
authors.affiliation: Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France.|INSERM UMR965, 75475, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Lozeron
authors.affiliation: Service de Physiologie Clinique-Explorations Fonctionnelles, AP-HP, Hôpital Lariboisière, 2, rue Ambroise Paré, 75475, Paris, France. nathalie.kubis@aphp.fr.|Université Paris Diderot, Sorbonne Paris Cité, 75475, Paris, France. nathalie.kubis@aphp.fr.|INSERM UMR965, 75475, Paris, France. nathalie.kubis@aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Kubis
mesh_terms: D000328:Adult; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D010243:Paralysis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D059348:Peripheral Nerve Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D049590:Postpartum Period; D011247:Pregnancy; D011379:Prognosis; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D020127:Recovery of Function; D012189:Retrospective Studies; D055815:Young Adult
keywords: Electrophysiological investigations; Intrapartum plexopathy; Intrinsic obstetric palsy; Maternal birth palsy; Obstetrical delivery; Postpartum lumbosacral plexopathy