PMID- 35764607
OWN - NLM
STAT- MEDLINE
DCOM- 20220630
LR  - 20230701
IS  - 2058-6124 (Electronic)
IS  - 2058-6124 (Linking)
VI  - 8
IP  - 1
DP  - 2022 Jun 28
TI  - Successful pregnancy and cesarean delivery in a tetraplegic, 
      home-invasively-mechanically-ventilated patient - case report.
PG  - 62
LID - 10.1038/s41394-022-00528-4 [doi]
LID - 62
AB  - INTRODUCTION: Pregnancies are rare in patients with severely disabilitating 
      spinal cord injuries (SCI) but increasing alongside social awareness concerning 
      reproductive equality. Physicians should be aware of several potential 
      complications during pregnancy and delivery, particularly autonomic dysreflexia. 
      CASE PRESENTATION: We report a successful pregnancy of a 32-year-old woman with a 
      severe SCI at the C2 level (C1-4 ASIA Impairment Scale grade A) and total 
      dependency on home invasive mechanical ventilation (HIMV), an extremely rare 
      treatment. An elective cesarean section was chosen as the delivery mode at 34 + 0 
      weeks of gestation. Both the mother and the child recovered well. DISCUSSION: 
      Severe spinal cord injury and dependency on mechanical ventilation are not 
      absolute contraindications for pregnancy. With careful planning, pregnancy is 
      possible also for patients with the most severe forms of SCI. Adequate pain 
      relief during cesarean delivery is required despite complete spinal cord injury 
      in order to avoid excessive hemodynamic responses and spinal reflexes. A 
      multidisciplinary team is needed to ensure safe pregnancy and delivery of these 
      high-risk pregnancies.
CI  - (c) 2022. The Author(s), under exclusive licence to International Spinal Cord 
      Society.
FAU - Jernman, Riina
AU  - Jernman R
AD  - Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland. 
      riina.jernman@hus.fi.
FAU - Vaananen, Antti
AU  - Vaananen A
AD  - Helsinki University Hospital, Anesthesiology and Intensive Care, Helsinki, 
      Finland.
FAU - Kreivi, Hanna-Riikka
AU  - Kreivi HR
AD  - Helsinki University Hospital, Heart and Lung Center, Pulmonary Medicine, 
      Helsinki, Finland.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20220628
PL  - England
TA  - Spinal Cord Ser Cases
JT  - Spinal cord series and cases
JID - 101680856
SB  - IM
MH  - Adult
MH  - *Autonomic Dysreflexia
MH  - Cesarean Section
MH  - Child
MH  - Family
MH  - Female
MH  - Humans
MH  - Pregnancy
MH  - Respiration, Artificial
MH  - *Spinal Cord Injuries/complications
PMC - PMC9240012
COIS- The authors declare no competing interests.
EDAT- 2022/06/29 06:00
MHDA- 2022/07/01 06:00
PMCR- 2023/06/28
CRDT- 2022/06/28 23:13
PHST- 2022/02/10 00:00 [received]
PHST- 2022/06/09 00:00 [accepted]
PHST- 2022/06/07 00:00 [revised]
PHST- 2022/06/28 23:13 [entrez]
PHST- 2022/06/29 06:00 [pubmed]
PHST- 2022/07/01 06:00 [medline]
PHST- 2023/06/28 00:00 [pmc-release]
AID - 10.1038/s41394-022-00528-4 [pii]
AID - 528 [pii]
AID - 10.1038/s41394-022-00528-4 [doi]
PST - epublish
SO  - Spinal Cord Ser Cases. 2022 Jun 28;8(1):62. doi: 10.1038/s41394-022-00528-4.