Spinal cord injury and pregnancy

Abstract

Spinal cord injuries occur more frequently in women than in the past because of the societal and cultural changes in this country. Female survivors of spinal cord injuries have an improved prognosis for return to independence and societal contribution over their counterparts of 15 to 20 years ago. Because fertility is not affected, it is reasonable to predict that perinatal centers will continue to see an increase in spinal cord-injured patients. The unique nature of the injury makes pregnancy in these women a challenging event. The objectives of care are to prevent the complications associated with pregnancy while supporting independence. A multidisciplinary team approach best serves these patients and provides the best possible outcome for both mother and baby.

Hiperreflexia autonômica em gestante tetraplégica: relato de caso

“…Devido a essas alterações na fisiologia respiratória das gestantes com trauma medular, alguns autores preconizam a monitorização da função respiratória com medições seriadas da capacidade vital 25 . Mulheres com capacidade vital inferior a 800 ml necessitam de assistência ventilatória e exercícios respiratórios para ajudar a prevenção das complicações respiratórias durante a gestação 35 . A imobilização prolongada provoca o aparecimento de osteoporose e atrofia muscular que são responsáveis pelas dificuldades técnicas para a realização do bloqueio espinhal.…”

“…Due to those changes in the respiratory physiology of pregnant women with medullary trauma, some authors recommend respiratory function monitoring with serial vital capacity measurements 25 . Women with vital capacity below 800 ml need ventilatory assistance and respiratory exercises to help prevent respiratory complications during gestation 35 . Prolonged immobilization leads to osteoporosis and muscle atrophy responsible for technical spinal block induction difficulties.…”

Discussing reproductive health in spinal care, part II: fertility issues

“…Data on female fertility and SCI is scarce. Women with SCI however, do experience prolonged amenorrhoea after injury, which can take up to 9 months [20,21]. To complicate matters, during this anovulatory phase, unpredictable ovulation might occur, which makes it even more important to properly consult patients on fertility, and contraception [20].…”