British Journal of Anaesthesia, Vol 75, Issue 5 522-526, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia
A. Holdcroft, F. B. Gibberd, R. L. Hargrove, D. F. Hawkins and C. I. Dellaportas
Prospective multidisciplinary audit from both hospital and community has
identified neurological complications persisting for more than 6 weeks in
association with pregnancy and delivery. They occurred at a frequency of 1
in 2530 deliveries in the North West Thames Region. Extradural analgesia
was considered contributory to a neurological disorder in one of 13,007
patients. The woman had prolonged paraesthesiae along a nerve root. The
types of sensory, motor and sympathetic neurological problems presented
ranged from transient problems to more serious disorders resulting in death
in one case. Seven of 19 patients had a continuing neurological disability
for more than 1 yr. Although obstetrics may be associated with lumbar and
sacral neurological disorders, problems occurred with the same frequency in
the upper as in the lower half of the body. Significant morbidity is not
being recognized in hospitals where women are being delivered and it is
within the community that these disorders are recognized. This has
implications for training, audit and risk assessment.
CLINICAL INVESTIGATIONS
Neurological complications associated with pregnancy
Royal Postgraduate Medical School, London; Chelsea and Westminster Hospital, London; Hammersmith Hospital, London; Regional Neurosciences Centre, Department of Neurology, Charing Cross Hospital, London SW6 5PX
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