Pregnancy and spinal cord injury 2014 TOG Flashcards
Lesions above T4, what is recommended in pregnancy?
A ventilation assessment
Issues wit lesions above T6 what risk?
Autonomic Dysreflexia in labour, a rise in BP 20-40mmHg is Dx of AD
Thermoregulation
Risk above T10
Altered perception of FM, unable to feel labour pains
Late preterm labour and UTI
Risk above T12
Increased risk malpresentation at term
Risk above L2-L4
Scar tissue in epidural space cause inadequate epidural analgesia
What features associated with all levels SCI
Increased risk anaemia
Increased risk pressure ulcers
Requirement for adequate analgesia for operative delivery/perineal repair
VTE score 1 immobility/wheelchair user
Diagram summarising this
Potential causes of AD
Urinary: Bladder distension, catheterisation, UTI
GI: Bowel impaction/distension, gallstones, uvular
Skin: Constrictive clothing, sunburn, pressure ulcer
Repro: Intercourse, menstruation, pregnancy, labour, delivery
Other DVT, PE, ETOH, caffeine, substance abuse, trump
Symptoms of AD
Nausea,a anxiety, malaise, prickling sensation in skull, rising in head, throbbing headache
Signs of AD
BP >20mmHg
Bradycardia
Prolonged PR, AV blood, ventricular ectopics, disappearance p wave
Fetal bradycardia
Pharmacological treatment AD
Nifedipine SL 10-40mg
GTN spray
IV labetolol
Hydralazine
Medical management of spams in pregnancy
Baclofen tablets or intrathecal pump
Oxybutinin for bladder
Diazepam
Do not give clonidine, tizanidine
