Autonomic dysreflexia.

The purpose of this article is to help perinatal nurses understand how to more effectively care for women in labor who have spinal cord injuries (SCIs), especially those women who develop the complication of autonomic dysreflexia (AD). AD is a syndrome that can occur in patients with SCIs above the level of T6. Its symptoms include dangerous paroxysmal hypertension, resulting from abnormal interplay between the parasympathetic and sympathetic nervous systems. While this syndrome was not commonly encountered by perinatal nurses in childbirth settings in the past, the dramatic improvements in both acute care and rehabilitation for women with SCI has increased the numbers of women with SCI who become pregnant and experience childbirth. Therefore, it is essential that perinatal nurses be made aware of how to effectively identify AD, and what steps to take should it occur.