Pregnancy in spinal cord-injured women, a cohort study of 37 pregnancies in 25 women
Autor: | Emmanuel Chartier-Kastler, Véronique Phé, B. Idiard-Chamois, H. Le Liepvre, Alexia Even, P. Denys, Aurélien Dinh, Gilberte Robain |
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Rok vydání: | 2016 |
Předmět: |
Adult
medicine.medical_specialty Population Urinary incontinence Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy Medicine Humans education Twin Pregnancy Spinal Cord Injuries Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine business.industry Obstetrics Infant Newborn Pregnancy Outcome Retrospective cohort study General Medicine Infant Low Birth Weight Delivery mode medicine.disease Pregnancy Complications Low birth weight Neurology Premature Birth Female Neurology (clinical) France medicine.symptom business 030217 neurology & neurosurgery Cohort study |
Zdroj: | Spinal cord. 55(2) |
ISSN: | 1476-5624 |
Popis: | A retrospective observational study. To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. NeuroUrology Department in a University Hospital, France. All consecutive SCI pregnant women managed between 2001 and 2014 were included. A preconceptional consultation was proposed whenever possible. Obstetrical and urological outcomes, delivery mode and complications were reported. Overall, thirty-seven pregnancies in 25 women, of a mean age of 32±4 years, were included. Thirty-five children were born alive (three miscarriages, a twin pregnancy) without complications except for a case of neonatal respiratory distress in premature twins born at 33 weeks. The mean birth weight was 2979±599 g. Twenty-one (57%) pregnancies benefited from preconceptional care. A weekly oral cyclic antibiotic programme was prescribed in 28 (75%) pregnancies. The main complications during pregnancy included pyelonephritis (30%), lower urinary tract infections (UTI) (32%), pressure sores (8.8%) and prematurity (12% deliveries before 37 weeks, with only one delivery before 36 weeks). Two patients suffered from autonomic dysreflexia, one with serious complication (brain haematoma). Caesarean sections were performed for 68% of deliveries (23/34) to prevent syringomyelia deterioration (n=10), stress urinary incontinence aggravation (n=3) or for obstetrical reasons (n=7). Mothers’ and infants’ outcomes were satisfying after pregnancy in SCI women, but required many adjustments. Pregnancy must be prepared by a preconceptional consultation, and managed by a multidisciplinary team involving specialists of neurological disability and pregnancy. |
Databáze: | OpenAIRE |
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