Chronic Pain Centre, St. Paul's Hospital, Vancouver, BC, Canada .
Neuromodulation. 2012 Nov-Dec;15(6):537-41; discussion 541. doi: 10.1111/j.1525-1403.2012.00448.x. Epub 2012 Apr 11.
Currently, the use of spinal cord stimulation (SCS) therapy is not recommended in pregnancy because the effects of SCS on the pregnancy and developing fetus are unknown. However, many SCS recipients are women of childbearing age who may later become pregnant. The purpose of the present report is to review and summarize the existing literature on the use of SCS therapy during the prenatal period.
We first present the case of a 38-year-old woman from our center who became pregnant after receiving an SCS implantation. We then provide a synopsis of previous reports that were identified in a literature search. We highlight the key findings from these cases as they relate to the course of pregnancy, fetal development, labor and delivery management, fertility, and technical complications.
In our literature review, we identified 12 cases of pregnancy in 8 women. To these we add the present case.
Women of childbearing age who are candidates for SCS implantation should be tested for pregnancy prior to implantation surgery. They also should be informed about the limited state of our scientific knowledge regarding the impact of this technology on reproductive health. For patients already implanted with SCS, decisions about ongoing use in the event of pregnancy should be made on an individual basis after a careful consideration of potential risks and benefits.
目前不建议在妊娠期间使用脊髓刺激 (SCS) 疗法,因为 SCS 对妊娠和发育中的胎儿的影响尚不清楚。然而,许多 SCS 受者是育龄妇女,她们以后可能会怀孕。本报告的目的是回顾和总结现有关于在产前使用 SCS 治疗的文献。
我们首先介绍了一位来自我们中心的 38 岁女性的病例,她在接受 SCS 植入后怀孕。然后,我们对文献检索中确定的先前报告进行了概述。我们重点介绍了这些病例与妊娠过程、胎儿发育、分娩管理、生育能力和技术并发症相关的关键发现。
在我们的文献综述中,我们确定了 8 名女性中的 12 例妊娠病例。在此基础上,我们又增加了本病例。
接受 SCS 植入术的育龄妇女在植入手术前应进行妊娠检测。还应告知她们,关于这项技术对生殖健康的影响,我们的科学知识还很有限。对于已经植入 SCS 的患者,如果怀孕,应在仔细考虑潜在风险和收益的基础上,根据个体情况决定是否继续使用。