Anaesthetic management of tetraplegic pregnant patients during child delivery: A systematic review

Abstract

Background: Pregnancy in spinal cord injured patients has specific issues that must be carefully addressed. However, guidelines for their management are scarce.

Methods: A systematic review of the literature regarding the anaesthetic management during delivery of pregnant patients with cervical spinal cord injury was performed on the electronic databases of PubMed (Medline) and Cochrane.

Results: Twenty-two papers were included. A higher incidence of preterm birth and caesarean delivery were seen. Anaesthetic management was diverse, although most pregnant patients received epidural analgesia. Autonomic dysreflexia symptoms were present in 51% of pregnancies.

Conclusion: Timely management of these patients could possibly reduce caesarean and preterm delivery rates, avoid or minimize common complications, as well as reduce costs. An early reference to anaesthesiology consultation and a multidisciplinary approach is recommended.

Keywords: Analgesia obstétrica; Autonomic dysreflexia; Complicaciones del parto; Disreflexia autónoma; Labour complications; Obstetric analgesia; Tetraplegia; Tetraplejia.