Embarazo en pacientes con lesión medular

Abstract

Background: The pregnancies in patients with spinal cord injury represent a challenge for obstetrics. The most common complications are infections of the respiratory and urinary tract, and the most severe is the autonomic hyperreflexia. Vaginal delivery is possible in lesions below T5, but above that level the inability to perceive contractions, to identify labor and perform straining leads to the need for a scheduled cesarean. Objective: To describe our experience and review the most appropriate management of paraplegic pregnant. Methods: Retrospective study in the period 2003-2014. There were 10 patients with 24 pregnancies: 6 spontaneous abortions, 1 induced abortion, leaving 17 for analysis pregnancies (one twin pregnancy). The evaluation is independent of the etiology or location of the lesion. Perinatal and maternal complications were analyzed. Results: The mean age was 33 years. The mean gestational age at delivery was 37 weeks: 12 to term (70.59[%]), 4 preterm deliveries (23.53[%]) and one unknow. There were 10 cesarean sections (58.82[%]) and 7 vaginal deliveries (41.18[%]). Average birth weight of 2940 g, none with intrauterine growth restriction. Conclusions: Our experience shows a high rate of prematurity and cesarean section, but with good maternal and perinatal outcomes, which makes it permissible for these patients can fulfill their procreative desire, overcoming his disability.