Problems with child care after successful pregnancy in a patient with spinal cord injury – a case study
More details
Hide details
Warsaw Medical University, Warsaw, Poland
Mazovian Centre of Rehabilitation, Warsaw and Konstancin-Jeziorna, Poland
Submission date: 2017-09-18
Acceptance date: 2017-12-01
Online publication date: 2018-06-18
Publication date: 2019-11-19
Corresponding author
Beata Tarnacka   

Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw, Barska 16/20, 02-315 Warszawa, Poland. Tel.: +48 603 944 804.
Pol. Ann. Med. 2018;25(2):258-261
Pregnancy in spinal cord injury (SCI) patient’s population is rare. The problems with child care are also rarely described in the literature.

To present a case of a woman with incomplete tetraplegia and problems during pregnancy and child care.

Case study:
A case of a 30-year-old SCI woman with C5 fracture due to a motor vehicle accident is described. She was admitted to our neurorehabilitation ward with severe tetraparesis and discharged able to walk with assistance. After discharge, the patient was referred by a senior physical medicine specialist in our outpatient clinic, and 4 years after her SCI, she got pregnant. Beyond acute clinical problems related to SCI, many chronic medical issues arose, such as orthostatic hypertension and constipation during her pregnancy. After 39 weeks of pregnancy, she was admitted for caesarean section because of somatosensory problems and received epidural analgesia. She gave birth to a male baby, weighing 3500 g. During the first weeks after delivery until now, she has had several problems with baby care due to limb paresis and spasticity, which she could not predict before.

Results and discussion:
For a mother with SCI, child care is restricted by many everyday problems occurring after delivery.

The management of pregnancy and delivery in this setting emphasises the importance of a multidisciplinary team. The knowledge of these problems can help prepare these patients for child care.

None declared.
Lezzoni L, Chen Y, Mc Lain A. Current pregnancy among women with spinal cord injury: findings from the US National Cord Injury Database. Spinal Cord. 2015;53(11):821–826.
Jazayeri S, Beygi S, Shokraneh F, Hagen EM, Rahimi-Movaghar V. Incidence of traumatic spinal cord injury worldwide: a systematic review. Eur Spin J. 2015;24(5):905–918.
Chamberlain J, Deriaz O, Hund-Georgiadis M, et al. Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland. Inj Epidemiol. 2015;2(1):28–39.
Burns A, Jackson B. Gynecological and reproductive issues in women with spinal cord injury. Phys Med Rehabil Clin N Am. 2001;12(1):183–199.
Bertschy S, Bostan C, Meyer T, Pannek J. Medical complications during pregnancy and childbirth in women with SCI in Switzerland. Spinal Cord. 2016;54(3):183–187.
Edwards J, Reid Y, Cozens D. Reproductive toxicity studies with oxybutynin hydrochloride. Toxicology. 1989;40(1):31–44.
Krasmik D, Krebs J, Van obhoven A, Pannek J. Urodynamic results, clinical efficacy, and complication rates of sacral anterior root stimulation in patients with neurogenic lower urinary tract dysfunction resulting from complete spinal cord injury. Neurol Urodyn. 2014;33(8):1202–1206.
McGregor J, Meeuwsen J. Autonomic hyperreflexia a mortal danger for spinal cord-damaged women in labour. Am J Obter Gynecol. 1985;151(3):330–333.
Lamb G, Tomski MA, Kaufman J, Maiman DJ. Is chronic spinal cord injury associated with increased risk of venous thromboembolism? J Am Paraplegia Soc. 1993;16(3):153–156.
James A. American College of Obstetricians and Gynecologists, Committee on Practice Bulletins – Obstetrics. ACOG Practice bulletin no. 123: thromboembolism in pregnancy. (Replaces Practice Bulletin No. 19, August 2000). Obstet Gynecol. 2011;118(3):718–729.
Teasell R, Hsieh J, Aubut J, Eng JJ, Krassioukov A, Tu L. Spinal Cord Injury Rehabilitation Evidence Review Research Team. Venous thromboembolism after spinal cord injury. Arch Phys Med Rehabil. 2009;90(2):232–245.
Jackson AB, Wadley V. A multicenter study of women’s self-reported reproductive health after spinal cord injury. Arch Phys Med Rehabil. 1999;80(11):1420–1428.
Adams M, Hicks A. Spasticity after spinal cord injury. Spinal Cord. 2005;43(10):577-86.
Delhaas E, Verhagen J. Pregnancy in quadriplegic patient treated with continuous intrathecal baclofen infusion to manage her severe spasticity. Case report. Paraplegia. 1992;30(7):527–528.
Ohry A, Peleg D, Goldman J, David A, Rozin R. Sexual function, pregnancy and delivery in spinal cord women. Gynecol Obster Invest. 1978;9(6):281–291.
Pebdani RN, Johnson KL, Amtmann D. Personal experience of pregnancy and fertility in individuals with spinal cord injury. Sex Disabil. 2014;32(1):65–74.
Aune G. Everyday challenges for mothers with spinal cord injury: a qualitative study. Scan J Dis Resarch. 2013;15(2):185–198.
Journals System - logo
Scroll to top