Hakeem Rashida, Neppe Cliff
CMO, Department of Obstetrics & Gynaecology, Joondalup Health Campus , Joondalup WA Australia .
Director, Department of Obstetrics & Gynaecology, Joondalup Health Campus , Joondalup WA Australia .
J Clin Diagn Res. 2016 Apr;10(4):QD06-7. doi: 10.7860/JCDR/2016/18797.7693. Epub 2016 Apr 1.
Maternal neurological injuries may be intrinsic to the labour and delivery process or may result directly or indirectly from obstetric or anaesthetic intervention. This intrinsic obstetric palsy is a rare complication of labour but can have devastating impact on a previously healthy mother. A 23-year-old gravida1, para0 who had epidural for labour analgesia, was augmented for slow progress and had a normal vaginal delivery. She was diagnosed post delivery with intrinsic obstetric palsy involving several peripheral nerves and lumbosacral nerve roots with a guarded prognosis. In this article we have discussed the risk factors and mechanisms of intrinsic obstetric palsy and proposed further investigation into the potential protective role of ambulatory analgesia i.e. CSE (Combined Spinal Epidural) or LDI (Low Dose Infusion).
产妇神经损伤可能是分娩过程中固有的，也可能直接或间接由产科或麻醉干预导致。这种原发性产科麻痹是分娩的一种罕见并发症，但可能对之前健康的母亲产生毁灭性影响。一名23岁初产妇，因分娩镇痛接受硬膜外麻醉，因产程进展缓慢使用了催产素，最终经阴道正常分娩。产后她被诊断为原发性产科麻痹，累及多条周围神经和腰骶神经根，预后不佳。在本文中，我们讨论了原发性产科麻痹的危险因素和机制，并建议进一步研究动态镇痛即腰麻-硬膜外联合阻滞（CSE）或低剂量输注（LDI）的潜在保护作用。
