Pregnancy in spinal cord injured women

Baker, Emily; Cardenas, Diana D.

doi:10.1016/s0003-9993(96)90041-6

Cited by 93 publications

(91 citation statements)

References 39 publications

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“…One was a prospective cohort study, 22 nine were retrospective case series [9][10][11][12][13][14]16,18,21 and four were case reports. 15,17,19,20 In the case series and the case reports, information was gathered by a retrospective review of the medical records or by interviews of women with SCI who have borne children (Table 2).…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Mission impossible? Urological management of patients with spinal cord injury during pregnancy: a systematic review

Pannek

Bertschy

2011

Spinal Cord

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Study design: A systematic literature review. Objectives: To systematically assess the existing knowledge about treatment of neurogenic lower urinary tract dysfunction (NLUTD) in pregnant women with traumatic spinal cord injury (SCI), as urologic management of these patients is mandatory, but no guidelines are available. Setting: Paraplegic center in Switzerland. Methods: Studies were identified by electronic search of PubMed and MedLine. Data were pooled and analyzed quantitatively. Results: The evidence level of all 14 reports (163 patients, 226 pregnancies) included was low. In 13 studies, information was gathered by a retrospective review of the medical records or by questionnaires. In all studies, reported data were incomplete. SCI was cervical in 34.7%, thoracic in 61.2% and lumbar in 4.1% of the pregnant women. In all 34.7% of the women used indwelling catheters, 25% performed intermittent catheterization, 11.5% used the Credé maneuver and 28.8% voided spontaneously. A total of 64% of the patients had at least one symptomatic urinary tract infection (UTI) during pregnancy. UTIs were more common in women with indwelling catheters (100%) than in those performing intermittent catheterization (38.5%), using the Credé technique (17%) or voiding spontaneously (53.3%). One study demonstrated a significant reduction in UTI during pregnancy without complications in mothers or infants. Conclusion: No evidence-based recommendations can be drawn from the existing literature to guide urologists in the management of NLUTD in pregnant women with SCI. The number of studies is small, and data acquisition and presentation are often inadequate. Thus, further research is urgently needed.

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Section: Study and Patient Characteristicsmentioning

confidence: 99%

Mission impossible? Urological management of patients with spinal cord injury during pregnancy: a systematic review

Pannek

Bertschy

2011

Spinal Cord

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“…Trauma during pregnancy is discussed mainly in the obstetric literature [1,4,5,11,12,17,18,21], but we did not find a single report on flexion-distraction spinal injuries in pregnant women. However, we did find papers questioning compulsory wearing of seat-belts for pregnant women because of the possible damage to the gravid uterus by forced compression in car accidents.…”

Section: Discussionmentioning

confidence: 89%

Thoracolumbar distraction fractures in advanced pregnancy: a contribution of two case reports

Tanchev¹,

Dikov²,

Novkov

2000

European Spine Journal

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“…[50] Normal kadınlara göre SKY'li kadınlarda da gebelik genellikle normal olmasına rağmen, gebelik ve doğum komplikasyonları daha sıktır. [51] Doğum sırasında otonomik disrefleksi, mesane komplikasyonları ve spastite sık gelişir. [51] Sezeryan ve düşük doğum ağırlıklı bebek oranı yüksektir.…”

Section: İkinci Basamak Tedaviunclassified

Sexual and reproductive abnormalities in patients with spinal cord injuries

Aşçı

Açıkgöz²,

Büyükalpelli³

2012

Turkish Journal of Urology

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Spinal cord injuries (SCIs) may cause predictable abnormalities in genital sexual arousal and changes in the ability to achieve orgasm. In this review, sexual dysfunction and reproductive abnormalities and their treatment possibilities in male and female patients with SCI were reviewed. Literature from 1982-2011 examining the neuroanatomy of sexual functions, sexual dysfunction and reproductive abnormalities and their treatment alternatives both in male and female patients with SCI was reviewed with PubMed. In both genders, the sympathetic, parasympathetic and motor-sensory innervations of genitals are localized at the T11-L2, and S2-4 and S2-3 spinal cord levels, respectively. Patients with lesions above or at level of T11-L2 have reflex erections but no psychogenic erections. Patients with lesions in between levels of L2 and S2 spinal segments have reflex and psychogenic erections. Patients with lesions at level of S2-3 or below can have psychogenic erections but no reflex erections. Patients with lesions above the T10 level have autonomic, somatic, vibration and electroejaculations but no nocturnal ejaculation. Patients with lesions at the level of the thoracolumbar (T11-L2) region can have electroejaculation but no autonomic, somatic, vibration and nocturnal ejaculations. Patients with lesions below the L2 levels can produce emissions and electroejaculation but no other type of ejaculation. Reproductive dysfunction in men with SCI is due to a combination of ED, ejaculatory failure, and abnormal semen parameters. Women with no lesions at the T11-L2 levels may have psychogenic genital vasocongestion, while reflex lubrication and orgasm is more prevalent in women who have preserved the sacral reflex arc (S2-S5). A better knowledge of neuroanatomy and neurophysiology in SCI patients provides a more predictable understanding of sexual and reproductive dysfunctions. ÖZETSpinal kord yaralanmaları (SKY) genital cinsel uyarımlarda öngörülebilir bozukluklara ve orgazma ulaşma yeteneğinde değişikliklere neden olabilir. Bu derlemede SKY'li erkek ve kadın olgularda cinsel işlev ve üre-me bozuklukları ile tedavi olanakları gözden geçirilmiştir. PubMed taraması ile 1982-2011 yılları arasında yayımlanmış literatür eşliğinde cinsel işlevlerin nöroanatomisi, spinal kord yaralanmalarında ortaya çıkan cinsel işlev ve üreme bozuklukları ile tedavi olanakları gözden geçirilmiştir. Her iki cinste genital sistemin sempatik, parasempatik ve motor-duyu inervasyonları sırasıyla T11-L2, S2-5, S2-3 spinal kord seviyelerinde lokalizedir. T11-L2 veya üzerindeki SKY'de refleks ereksiyonlar sürdürülürken, psikojenik (nokturnal) ereksiyonlar kaybolabilir. L2-S2 spinal segmentler arasındaki lezyonlarda ise her iki ereksiyon tipi sürdü-rülürken, S2 seviyesi altında ve komplet konus medullaris lezyonlarında sadece psikojenik ereksiyonlar sürdürülür. T10 ve üzeri lezyonlarda otonomik, somatik, vibro-ve elektro-ejakulasyonlar sürdürülürken, nokturnal ejakulasyon görülmez. T10 altındaki tüm lezyonlarda somatik ve vibroejakulasyon kaybolur...

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Pregnancy in spinal cord injured women

Cited by 93 publications

References 39 publications

Mission impossible? Urological management of patients with spinal cord injury during pregnancy: a systematic review

Mission impossible? Urological management of patients with spinal cord injury during pregnancy: a systematic review

Thoracolumbar distraction fractures in advanced pregnancy: a contribution of two case reports

Sexual and reproductive abnormalities in patients with spinal cord injuries

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