INTRODUCTION: Pregnancies in women with spinal cord injury (SCI) are at greater risk of morbidity and mortality. Although pregnancy after SCI is well elaborated in the literature, SCI occurring during pregnancy is rarely reported. Abrupt changes in the body physiology because of SCI and the resulting disability add a risk to maternal and fetal well-being. Not only is the burden of care increased but there is also a higher risk of developing pressure ulcers, urinary tract infections, autonomic instability, intrauterine growth retardation and venous thromboembolism. CASE PRESENTATION: We report a case of a 32-year-old lady who had a traumatic SCI at C6 level during the second trimester of her pregnancy. She was admitted to a tertiary care rehabilitation facility after 2 months of her injury. This case highlights the comprehensive approach toward her management, including rehabilitation, spinal intervention and obstetrical care. To the best of our knowledge, this is the first case report of its kind from the Middle East. DISCUSSION: Multi-system involvement due to SCI during pregnancy results in intense physiological changes that affect the treatment options for anesthesia, surgery, labor and comprehensive rehabilitation. This case report emphasizes the need for well-equipped, specialized centers for similar patients in developing health systems and aims to increase the awareness for management of SCI during pregnancy using a comprehensive approach.
INTRODUCTION: Pregnancies in women with spinal cord injury (SCI) are at greater risk of morbidity and mortality. Although pregnancy after SCI is well elaborated in the literature, SCI occurring during pregnancy is rarely reported. Abrupt changes in the body physiology because of SCI and the resulting disability add a risk to maternal and fetal well-being. Not only is the burden of care increased but there is also a higher risk of developing pressure ulcers, urinary tract infections, autonomic instability, intrauterine growth retardation and venous thromboembolism. CASE PRESENTATION: We report a case of a 32-year-old lady who had a traumatic SCI at C6 level during the second trimester of her pregnancy. She was admitted to a tertiary care rehabilitation facility after 2 months of her injury. This case highlights the comprehensive approach toward her management, including rehabilitation, spinal intervention and obstetrical care. To the best of our knowledge, this is the first case report of its kind from the Middle East. DISCUSSION: Multi-system involvement due to SCI during pregnancy results in intense physiological changes that affect the treatment options for anesthesia, surgery, labor and comprehensive rehabilitation. This case report emphasizes the need for well-equipped, specialized centers for similar patients in developing health systems and aims to increase the awareness for management of SCI during pregnancy using a comprehensive approach.
Authors: Ajmal Zemmar; Ahmed Al-Jradi; Vincent Ye; Ismail Al-Kebsi; Hugo Andrade-Barazarte; Emal Zemmar; Josue Avecillas-Chasin; Iype Cherian; Andrei V Krassioukov; Juha Hernesniemi Journal: Surg Neurol Int Date: 2018-12-24