Wasiak Krzysztof, Czajkowski Krzysztof, Frasuńska Justyna
Department of Rehabilitation, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland.
Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
J Spinal Cord Med. 2023 Jul;46(4):692-696. doi: 10.1080/10790268.2021.1965336. Epub 2021 Nov 2.
Spinal cord injury (SCI) sustained during pregnancy may be dangerous to the mother and her child. The risk is associated both with necessary diagnostic work-up and with the therapeutic process (radiographic investigations, surgical procedures, anesthesia, spinal shock, SCI complications, delivery). However, infant care is an enormous challenge for a woman with motor disability. The authors present a case report concerning the problems of treatment, rehabilitation and infant care in an SCI woman. To our knowledge, it is the first paper to describe SCI at such an early stage of gestation (2.5 weeks of gestational age/WGA).
A 20-year old paraplegic woman after SCI was pregnant. The period of diagnostics (MRI, X-ray), surgery and rehabilitation was associated with minor complications for the mother and no complications for the child. At discharge from the rehabilitation center the patient presented Th11 paraplegia (AIS-C), 24.5 WGA, and she could walk using a walker with a knee-ankle-foot-orthosis on the right and an ankle-foot-orthosis on the left lower limb. She delivered at 38 WGA via cesarean section (girl, birth weight 2960 g, length 50 cm, APGAR = 9 and 10). Bathing the baby and walking with it were the main problems of the post-delivery period.
Factors potentially threatening the mother and child's health in SCI during pregnancy do not always contribute to the complications of the clinical status and health of the child. Comprehensive approach to the treatment, rehabilitation and care of pregnant women with SCI facilitates the course of pregnancy, delivery and child care.
孕期发生的脊髓损伤（SCI）对母亲及其胎儿可能具有危险性。这种风险与必要的诊断检查以及治疗过程（影像学检查、外科手术、麻醉、脊髓休克、SCI并发症、分娩）均相关。然而，对于有运动障碍的女性而言，照顾婴儿是一项巨大的挑战。作者呈现了一例关于一名SCI女性的治疗、康复及婴儿护理问题的病例报告。据我们所知，这是第一篇描述在妊娠如此早期阶段（妊娠龄2.5周/WGA）发生SCI的论文。
一名20岁的SCI后截瘫女性怀孕了。诊断期（MRI、X线）、手术及康复过程中母亲出现了轻微并发症，胎儿未出现并发症。从康复中心出院时，患者存在胸11平面截瘫（AIS-C），妊娠龄24.5周，她能够借助助行器行走，右下肢佩戴膝踝足矫形器，左下肢佩戴踝足矫形器。她在妊娠38周时通过剖宫产分娩（女孩，出生体重2960g，身长50cm，阿氏评分=9分和10分）。产后阶段的主要问题是给婴儿洗澡以及带着婴儿行走。
孕期SCI中潜在威胁母亲和胎儿健康的因素并不总是会导致临床状况及儿童健康出现并发症。对SCI孕妇进行综合的治疗、康复及护理有助于妊娠、分娩及儿童护理的顺利进行。
