H Le Liepvre1,2, A Dinh3, B Idiard-Chamois4, E Chartier-Kastler5, V Phé5, A Even1, G Robain2, P Denys1. 1. PMR Department, Hôpital Raymond Poincare, Paris Ile de France Ouest University, Garches, France. 2. PMR Department, Hôpital Rothschild, Pierre and Marie Curie University, Paris, France. 3. Infectious Diseases Department, Hôpital Raymond Poincare, Paris Ile de France Ouest University, Garches, France. 4. Department of Obstetrics, Institut Mutualiste Montsouris, Paris, France. 5. Urology Department, Hôpital Pitié Salpétrière, Pierre and Marie Curie University, Paris, France.
Abstract
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. SETTING: NeuroUrology Department in a University Hospital, France. METHODS: All consecutive SCI pregnant women managed between 2001 and 2014 were included. A preconceptional consultation was proposed whenever possible. Obstetrical and urological outcomes, delivery mode and complications were reported. RESULTS: Overall, thirty-seven pregnancies in 25 women, of a mean age of 32±4 years, were included. Thirty-five children were born alive (three miscarriages, a twin pregnancy) without complications except for a case of neonatal respiratory distress in premature twins born at 33 weeks. The mean birth weight was 2979±599 g. Twenty-one (57%) pregnancies benefited from preconceptional care. A weekly oral cyclic antibiotic programme was prescribed in 28 (75%) pregnancies. The main complications during pregnancy included pyelonephritis (30%), lower urinary tract infections (UTI) (32%), pressure sores (8.8%) and prematurity (12% deliveries before 37 weeks, with only one delivery before 36 weeks). Two patients suffered from autonomic dysreflexia, one with serious complication (brain haematoma). Caesarean sections were performed for 68% of deliveries (23/34) to prevent syringomyelia deterioration (n=10), stress urinary incontinence aggravation (n=3) or for obstetrical reasons (n=7). CONCLUSIONS: Mothers' and infants' outcomes were satisfying after pregnancy in SCI women, but required many adjustments. Pregnancy must be prepared by a preconceptional consultation, and managed by a multidisciplinary team involving specialists of neurological disability and pregnancy.
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. SETTING: NeuroUrology Department in a University Hospital, France. METHODS: All consecutive SCI pregnant women managed between 2001 and 2014 were included. A preconceptional consultation was proposed whenever possible. Obstetrical and urological outcomes, delivery mode and complications were reported. RESULTS: Overall, thirty-seven pregnancies in 25 women, of a mean age of 32±4 years, were included. Thirty-five children were born alive (three miscarriages, a twin pregnancy) without complications except for a case of neonatal respiratory distress in premature twins born at 33 weeks. The mean birth weight was 2979±599 g. Twenty-one (57%) pregnancies benefited from preconceptional care. A weekly oral cyclic antibiotic programme was prescribed in 28 (75%) pregnancies. The main complications during pregnancy included pyelonephritis (30%), lower urinary tract infections (UTI) (32%), pressure sores (8.8%) and prematurity (12% deliveries before 37 weeks, with only one delivery before 36 weeks). Two patients suffered from autonomic dysreflexia, one with serious complication (brain haematoma). Caesarean sections were performed for 68% of deliveries (23/34) to prevent syringomyelia deterioration (n=10), stress urinary incontinence aggravation (n=3) or for obstetrical reasons (n=7). CONCLUSIONS: Mothers' and infants' outcomes were satisfying after pregnancy in SCI women, but required many adjustments. Pregnancy must be prepared by a preconceptional consultation, and managed by a multidisciplinary team involving specialists of neurological disability and pregnancy.
Authors: G J Daskalakis; C N Katsetos; I S Papageorgiou; A J Antsaklis; E K Vogas; V I Grivachevski; S K Michalas Journal: Eur J Obstet Gynecol Reprod Biol Date: 2001-07 Impact factor: 2.435
Authors: Jérôme Salomon; Alexis Schnitzler; Yves Ville; Isabelle Laffont; Christian Perronne; Pierre Denys; Louis Bernard Journal: Int J Infect Dis Date: 2008-11-04 Impact factor: 3.623