A 35-year-old woman, gravida 2, para 0, was seen at 20 weeks' gestation with complete T10 spinal cord transection at age 15 years, subsequent bilateral total leg amputation, urinary diversion, colostomy, and lumbar spine resection. Pregnancy complications included recurrent urinary tract infections, preterm contractions without cervical change, lumbosacral abscesses, and fetal malpresentation. Delivery was through cesarean section near term.