Neurological Complications Associated with Pregnancy

Self-reported post-discharge symptoms following obstetric neuraxial blockade

“…19 Recent large series estimate incidences range from 0.8 to 5.4 per 10,000, 7,9,20,21 but are limited by the fact that some reports are retrospective. Studies of neuropathy in obstetric patients are often unable to distinguish between obstetric and anaesthetic aetiology because those receiving epidural analgesia for longer, more difficult labours are also those more at risk of developing intrinsic obstetric palsy.…”

“…The median [IQR] time post neuraxial block for headache presentation was 7 [5][6][7][8][9] days. Four patients (9%) complaining of headache were considered to have postdural puncture headache (PDPH) and were treated with an epidural blood patch.…”

“…Of these there was a higher proportion of vaginal deliveries (52%) The median [IQR] time to presentation in this group was 8 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] days. Eight (24%) were referred to a neurologist.…”

“…Patients reported backache later than headache, with a median [IQR] time of 13 [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] days.…”

“…7,8 Holdcroft identified persistent neurological complications associated with pregnancy that were missed in hospital during the postnatal stay and only recognised later in the community setting. 9 Theirs is the only prospective study to date on late presentation of morbidity, but is limited to persistent neurological complications and does not reflect modern practices on early discharge. Given current cost pressures on earlier hospital discharge, often before the expected onset of neuraxial block morbidity, we sought to establish the incidence of complications of neuraxial analgesia and anaesthesia presenting post-discharge at a single tertiary obstetric centre.…”