Sacral Neuromodulation in Pregnant Women—A Case Report and Literature Review

Szymański, Jacek Krzysztof; Słabuszewska-Jóźwiak, Aneta; Jakiel, Grzegorz

doi:10.3390/ijerph19148340

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…Case of a 35‐year‐old pregnant lady with an overactive bladder who reacted well to SNM while being resistant to pharmaceutical treatment was presented by Szymanski et al 32 The patient made the decision not to turn off the neuromodulator, and after a normal pregnancy, she gave delivery through cesarean to a healthy female infant.…”

Section: Resultsmentioning

confidence: 99%

Is sacral neuromodulation effective and safe in pregnancy? A systematic review

Salehi‐Pourmehr,

Atayi,

Mahdavi

et al. 2023

Neurourology and Urodynamics

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Objective: We systematically assessed all available evidence on the efficacy and safety of sacral neuromodulation (SNM) in pregnancy.Methods: On September 2022, a thorough search was done on Ovid, PubMed, Scopus, ProQuest, Web of Science, and The Cochrane Library. We chose studies that included pregnant women who had SNM previously. Two authors independently evaluated the quality of the study using a standardized tool of JBI. Studies were given a risk of bias rating of low, moderate, or high. Given the descriptive nature of this study, we utilized descriptive statistics to report demographic and clinical features. For continuous variables, we used mean and standard deviation, and for dichotomous data, we used frequencies and percentages. Results: Out of 991 abstracts screened, only 14 studies met our inclusion criteria and were included in the review. Overall, the quality of the evidence available from the literature is low based on the design of the included studies. Fifty-eight women, including 72 pregnancies, had SNM.The indication of SNM implantation was filling phase disorders in 18 cases (30.5%), voiding dysfunction in 35 women (59.3%), IC/BPS in two cases (3.5%), and fecal incontinence. In 38 pregnancies (58.5%), the SNM status was ON during pregnancy. Forty-nine cases delivered a full-term baby (75.4%), 12 cases had pre-term labor (18.5%), two miscarriages, and two postterm pregnancies happened. The most complications in patients with devices were urinary tract infection in 15 women (23.8%), urinary retention in six patients (9.5%), and pyelonephritis in two cases (3.2%). The findings revealed that when the device was deactivated, 11 cases out of the 23 patients (47.8%) had full-term pregnancies, while in ON status, 35 out of the 38 pregnant women (92.1%) had full-term pregnancies. Nine preterm labors in OFF (39.1%), and two in ON status (5.3%) were recorded. The results revealed that this difference was statistically significant (p = 0.002), and those who turned SNM of them off had more preterm labor. Although the studies reported all neonates had a healthy status, two children had chronic

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Section: Resultsmentioning

confidence: 99%

Is sacral neuromodulation effective and safe in pregnancy? A systematic review

Salehi‐Pourmehr,

Atayi,

Mahdavi

et al. 2023

Neurourology and Urodynamics

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“…About three months after the implant, the patient informed the pain therapy service that she was pregnant, raising questions about the possible effects of neurostimulation on the fetus. After extensive literature searches and discussions within our team, as well as consultation with experts, we explained to the patient that the findings in the literature were often contradictory and thus did not provide any clear conclusions [ 43 , 44 , 45 , 46 , 47 ]. In fact, there are no absolute certainties dispelling any possible doubt about the health of the fetus [ 47 ].…”

Section: Case Presentationmentioning

confidence: 99%

“…After extensive literature searches and discussions within our team, as well as consultation with experts, we explained to the patient that the findings in the literature were often contradictory and thus did not provide any clear conclusions [ 43 , 44 , 45 , 46 , 47 ]. In fact, there are no absolute certainties dispelling any possible doubt about the health of the fetus [ 47 ].…”

Section: Case Presentationmentioning

confidence: 99%

Neurostimulation for Chronic Low Back Pain during Pregnancy: Implications for Child and Mother Safety

Innamorato

Cascella

Bignami

et al. 2022

IJERPH

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Pain therapy for low back pain in pregnancy is a very topical issue. In fact, it is necessary to balance the patient’s needs to control pain with the need to manage a pregnancy without negative effects on the fetus. We report a case of a 37-year-old woman with low back pain treated with neurostimulation before pregnancy. She described severe chronic low back pain unresponsive to pharmacologic treatments. We first implanted a subcutaneous stimulator into the patient, and then a definitive stimulator resulting in excellent pain control. The improvement in her quality of life allowed the woman to become pregnant. We decided to stop neurostimulation with the patient during pregnancy. The patient completed her pregnancy without complications and the baby was born healthy. During the pregnancy, the woman took only paracetamol when needed. However, this painful symptomatology, completely anecdotal, is not attributable solely to the previous spine problem but probably also to the changes occurring during pregnancy. At the end of pregnancy, the neurostimulator was reactivated without any discomfort for the patient, who is now pain free. This case report provides a first line of evidence of a possible treatment of low back pain in women intending to become pregnant, with risk-free management for both the patient and the child.

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Migration of a sacral neuromodulation electrode after vaginal delivery in a female patient with non-obstructive urinary retention

El-Akri,

Peyronnet

2024

The French Journal of Urology

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Sacral Neuromodulation in Pregnant Women—A Case Report and Literature Review

Cited by 3 publications

References 26 publications

Is sacral neuromodulation effective and safe in pregnancy? A systematic review

Is sacral neuromodulation effective and safe in pregnancy? A systematic review

Neurostimulation for Chronic Low Back Pain during Pregnancy: Implications for Child and Mother Safety

Migration of a sacral neuromodulation electrode after vaginal delivery in a female patient with non-obstructive urinary retention

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