Lower-limb neurologic deficit after vaginal delivery: a prospective observational study

Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery

“…For the cases group, midwives managing postpartum care were asked to systematically record every complaint of neurological deficit and to notify the obstetrician in charge of the ward that a neurological examination should be performed to medically confirm the deficit. These cases have previously been described 9 . Briefly, more than 80% of the injuries reported were unilateral, two‐thirds were sensory, and they primarily concerned the femoral territory.…”

Learning from the law. A review of 21 years of litigation for nerve injury following central neuraxial blockade in obstetrics

“…A prospective audit of all postpartum women found an incidence of 1 in 2530 for a neurological deficit lasting longer than 6 weeks, with epidural considered contributory in only 1 in 13,000 [16]. A recent prospective French study found an incidence of postpartum neuropathy of 0.3%, with 84% of lesions being in the femoral nerve territory and 69% resolving within six weeks [17]. This strongly suggests that childbirth by itself is a more common mechanism of nerve injury than neuraxial anaesthesia.…”

Lower Extremity Nerve Injury in Childbirth: AWHONN Practice Brief Number 11

“…Impairments can be unilateral or bilateral. Lower extremity nerve injury generally resolves within 2 to 6 months, although symptoms may persist for years or be permanent (Haller et al, 2017;O'Neal et al, 2015;Tournier et al, 2019).…”

“…Misdiagnosis and loss to follow-up also make the incidence difficult to determine (Haller et al, 2017;Madson, 2014;Richard et al, 2017). Among the five studies on LENI conducted worldwide since 2002, researchers reported various incidence rates: 0.3% (Tournier et al, 2019), 0.6% (Dar et al, 2002), 0.92% (Wong et al, 2003), 0.96% (Haller et al, 2017), and 2.3% (Richard et al, 2017). These reported rates are similar to those for shoulder dystocia (0.2%-3%; American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics, 2017), postpartum venous thrombosis (0.05%-0.2%; American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics, 2018), and postpartum hemorrhage (3%; Reale et al, 2020).…”