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Neural Injury During Pregnancy and Childbirth

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Book cover Musculoskeletal Health in Pregnancy and Postpartum

Abstract

Neural injury is a fortunately rare occurrence during pregnancy or childbirth. The incidence of intrapartum nerve injury is thought to be 0.92 %. Lateral femoral cutaneous neuropathy (meralgia paresthetica) is the most common neuropathy seen during both pregnancy and delivery. The femoral nerve, lumbosacral plexus, sciatic nerve, obturator nerve, and common peroneal nerve are other possible sites of injury. The pudendal nerves are thought to be very commonly injured during vaginal delivery—some studies estimate that up to 80 % of vaginal births can be complicated by pudendal neuropathy, which may contribute to the development of postpartum urinary and fecal incontinence. Neuropathies during pregnancy and childbirth are most often caused by traction or compression; focal demyelination is more common than axonal injury. Cesarean sections can also be complicated by neural injury, either due to malpositioning or poor retractor placement. Most neuropathies of pregnancy and delivery resolve spontaneously within 2–6 months’ time. The diagnosis of neuropathy is largely clinical in the acute timeframe after childbirth, although for women with symptoms that persist longer than 3 weeks, electrodiagnosis can play a significant role in the localization of the lesion and determination of prognosis. Treatment of neuropathies during pregnancy after childbirth can include physical therapy, supportive orthoses, medication management, injections, or surgical neurolysis or neurectomy for intractable cases.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9055, USA

    Kelly M. Scott MD

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  1. Kelly M. Scott MD
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Correspondence to Kelly M. Scott MD .

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Editors and Affiliations

  1. Department of Obstetrics & Gynecology, Loyola University, Maywood, Illinois, USA

    Colleen M. Fitzgerald

  2. Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas, USA

    Neil A. Segal

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Scott, K.M. (2015). Neural Injury During Pregnancy and Childbirth. In: Fitzgerald, C., Segal, N. (eds) Musculoskeletal Health in Pregnancy and Postpartum. Springer, Cham. https://doi.org/10.1007/978-3-319-14319-4_6

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