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Postpartum lumbosacral radiculopathy: a neuraxial anaesthesia complication or an intrinsic obstetric palsy?
  1. Leonor Silva Sousa1,
  2. Jânia Pacheco1,
  3. Catarina Reis-de-Carvalho2,3 and
  4. Filipa Lança1
  1. 1Anesthesiology, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
  2. 2PTCSRT, Harvard University, Cambridge, Massachusetts, USA
  3. 3Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
  1. Correspondence to Catarina Reis-de-Carvalho; catarinareiscarvalho{at}gmail.com

Abstract

Postpartum peripheral nerve disorders are an uncommon obstetrical complication, with most cases resulting from intrinsic obstetric palsies. We present the case of a full-term nulliparous pregnant 33-year-old woman with a vacuum-assisted vaginal delivery due to a prolonged second stage of labour and occipitoposterior position of the fetal head. For analgesia, a combined spinal–epidural technique was used. Four hours after delivery, the patient experienced a painless asymmetric motor deficit and hypoesthesia in the lower limbs, followed by sphincter disturbance. Emergent MRI was unremarkable. Electromyography showed signs of a bilateral lumbosacral radiculopathy. The patient experienced a gradual recovery over the following 2 months. Although a definitive aetiological diagnosis could not be confirmed, a lumbosacral polyradiculopathy due to intrinsic obstetric complication was considered. The patient presented several risk factors known to be associated with intrinsic obstetric palsies. Obstetricians and anaesthesiologists have an important role in preventing and diagnosing postpartum peripheral nerve disorders.

  • anaesthesia
  • medical education
  • peripheral nerve disease
  • obstetrics and gynaecology
  • pregnancy

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Footnotes

  • Contributors LSS: Drafting the manuscript; critical revision. CRC: Critical revision. JP: Critical revision. FL: Critical revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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