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 Release 21.0, Jan 2008
 
Chapter : ch15. Obstetics & Gynecology Section : Maternal Assessment During Pregnancy
  Monitoring a Pregnant Woman with a Spinal Cord Injury for Possible Complications

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Overview :

A woman with spinal cord injury can become pregnant and deliver healthy children. However, the woman needs to be monitored for early detection of certain complications before, during and after delivery.

 

Common complications that can occur before, during and after delivery:

(1) autonomic dysreflexia/hyperreflexia (especially if the level of injury is above T6 and if the woman is induced with pitocin/oxytocin)

(2) decubital ulceration

(3) wound dehiscence (including episiotomy dehiscence)

(4) urinary tract infection

(5) urinary and/or fecal incontinence

(6) anemia

(7) thrombophlebitis

(8) problems in weight transfer

(9) nausea

(10) preeclampsia or toxemia (which needs to be differentiated from autonomic dysreflexia)

(11) seizures

(12) bladder stones

(13) breakdown of a spinal fusion

(14) cardiac arrhythmias

 

Peripartum problems may include:

(1) failure to detect labor pains

(2) inability to bear down

(3) failure to progress

(4) premature cervical dilatation and labor

(5) delivery of an infant small for gestational age

(6) abnormal fetal presentation

(7) uterine atony post-delivery

 

  References:

Charlifue SW, Gerhart KA, et al. Sexual issues for women with spinal cord injuries. Paraplegia. 1992; 30: 192-199.

Cross LL, Meythaler JM, et al.  Pregnancy following spinal cord injury. West J Med. 1991; 154: 607-611.

Cross LL, Meythaler JM, et al. Pregnancy, labor and delivery post spinal cord injury. Paraplegia. 1992; 30: 890-902.

Sipski ML. The impact of spinal cord injury on female sexuality, menstruation and pregnancy: A review of the literature. J Am Paraplegia Society. 1991; 14: 122-126.

Verduyn WH. Pregnancy and delivery in tetraplegic women. J Spinal Cord Med. 1997; 20: 371-374.

Young BK, Katz M, Klein SA. Pregnancy after spinal cord injury: altered maternal and fetal response to labor. Obstet Gynecol. 1983; 62: 59-63.

 

 

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