[Is the epidural analgesia to blame when it comes to neurological complications following labor?].

BACKGROUND

One of every four parturient in Norway receives epidural analgesia during labour. Even though epidural analgesia is considered very safe, there is a tendency to blame the epidural whenever there are neurological complications after labour.

METHODS

This paper presents a case report on a woman who developed femoral mononeuropathy after labour. The various neurological complications after labour are discussed.

DISCUSSION

Gynaecologists, neurologists, mid-wives and even anaesthesiologists seem unaware of the fact that the incidence of neurological complications are four to five times higher as a result of the labour per se than complications caused by the epidural. Peripheral neurological symptoms after labour occur in 1:2-3,000 labours. Postpartum drop-foot and femoral mononeuropathy are the most frequent complications. Half of all parturients will experience low back pain during pregnancy and/or labour, and one in four will complain of headache in the immediate postpartum period. Urinary bladder dysfunction after pregnancy is not uncommon, but the incidence is the same among mothers who have received epidural analgesia and those who have not. Complications after epidural analgesia, such as haematoma, abscesses and direct nerve damage are extremely rare, but need immediate treatment.