Pregnancy in paraplegic patients: Two case reports

Oppenhimer, William M.

doi:10.1016/0002-9378(71)90574-6

Cited by 26 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aggressive prevention and treatment of anaemia is recommended [77, 83], with transfusion or iron supplements. The risk of thrombo‐embolic complications is further increased during pregnancy [84].…”

Section: Spinal Patients and Obstetricsmentioning

confidence: 99%

“…Autonomic dysreflexia may occur up to 48 h after delivery and it is often appropriate to leave the epidural catheter in situ for this time [85]. The headache and hypertension of pre‐eclampsia may occasionally be mistaken for that of autonomic dysreflexia [84]. If epidural anaesthesia fails to control blood pressure, nifedipine, hydralazine or verapamil may be given.…”

Section: Spinal Patients and Obstetricsmentioning

confidence: 99%

See 1 more Smart Citation

Anaesthesia for chronic spinal cord lesions

1998

View full text Add to dashboard Cite

SummaryIncreasing numbers of patients with spinal cord injury present for surgery or obstetric care. Spinal cord injury causes unique pathophysiological changes. The most important peri-operative dangers are autonomic dysreflexia, bradycardia, hypotension, respiratory inadequacy and muscle spasms. Autonomic dysreflexia is suggested by headache, sweating, bradycardia and severe hypertension and may be precipitated by surgery, especially bladder distension. Patients with low, complete lesions, undergoing surgery below the level of injury, may safely do so without anaesthesia provided there is no history of autonomic dysreflexia or troublesome spasms. An anaesthetist should be present to monitor the patient in this situation. General anaesthesia of sufficient depth is effective at controlling spasms and autonomic dysreflexia but hypotension and respiratory dysfunction are risks. There is a growing consensus that spinal anaesthesia is safe, effective and technically simple to perform in this group of patients. We present a survey of 515 consecutive anaesthetics in cord-injured patients and a review of the current literature on anaesthesia for patients with chronic spinal cord lesions. Dramatic improvements in the care of spinal cord injury patients have been achieved over the last few decades [1]. The active management of urinary tract and respiratory complications has lead to a decrease in mortality from renal and respiratory failure. Overall mortality decreased from over 80% at the time of World War I to less than 2% by the early 1980s. The implications of increased survival are an increase in the prevalence of spinal cord injuries, an increase in the numbers of patients presenting for elective surgery and an ever increasing number of spinal cord injured patients who develop further medical conditions as the result of normal ageing.Although the majority of spinal cord injured patients currently undergo elective surgery in specialised spinal units, the appearance of such patients on operating lists of other hospitals is likely to increase. Anaesthesia in the cord-injured patient poses unique difficulties. An understanding of the relevant pathophysiology assists in the provision of safe peri-operative care.

show abstract

Section: Spinal Patients and Obstetricsmentioning

confidence: 99%

Section: Spinal Patients and Obstetricsmentioning

confidence: 99%

Anaesthesia for chronic spinal cord lesions

1998

View full text Add to dashboard Cite

show abstract

“…The increased susceptibility to venous thrombosis in the spinal paralysed is increased even further by pregnancy. (Oppenhimer, 1971).…”

Section: Other Complications During Pregnancy and Birthmentioning

confidence: 99%

Pregnancy and autonomic hyperreflexia in patients with spinal cord lesions

1987

View full text Add to dashboard Cite

Symptoms of autonomic hyperreflexia in patients with complete and incomplete paraplegia above D 7 can be caused by almost any stimulus in the abdominal area or in the lower extremities, specifically during parturition by the uterine contractions. The symptoms vary from pilo-erection and outbreaks of sweating to serious blood pressure crises and cerebrovascular accidents. Epidural anaesthesia and general anaesthesia are effective as therapy and also as prophylaxis. Frequent complications are anemia and urinary tract infections. Changes in bladder function as a result of pregnancy and childbirth were observed. Paraplegic expectant mothers experience premature labour pains more frequently than do others, and this implies the necessity for earlier clinical surveillance up to the time of delivery. The secondary uterine inertia frequently requires an operative termination of the birth. The perception of labour pains is clearly possible also with lesions above D 10.

show abstract

“…Autonomic hyperreflexia is usually unmistakable to the experienced clinician; however in other departments in a hospital it may be easily missed. For example autonomic hyperreflexia frequently occurs during labor and delivery and can be misdiagnosed in that setting as preeclampsia (Oppenheimer, 1971). In this case the hyperreflexia can be diminished by the use of ganglionic blocking agents several weeks prior the due date (Oppenheimer, 1971).…”

mentioning

confidence: 99%

Autonomic Hyperreflexia

Ma¹

2000

Rehabilitation Nursing

View full text Add to dashboard Cite

Autonomic hyperreflexia is a dramatic complication of injuries to the spinal cord above the sixth thoracic vertebra. Knowledge of the pathogenesis and specific treatment measures are essential to develop a rational plan of nursing intervention. At the time of the original publication, the author was director of nursing, Rehabilitation Institute of Detroit, and a member of the adjunct faculty at Wayne State University, College of Nursing. Previous to that, she had been a nurse specialist in rehabilitation with the responsibility for directing and providing a continuity of nursing care for spinal cord injured patients.

show abstract

Pregnancy in paraplegic patients: Two case reports

Cited by 26 publications

References 8 publications

Anaesthesia for chronic spinal cord lesions

Anaesthesia for chronic spinal cord lesions

Pregnancy and autonomic hyperreflexia in patients with spinal cord lesions

Autonomic Hyperreflexia

Contact Info

Product

Resources

About