PREGNANCY AND DELIVERY IN WOMEN WITH A TRAUMATIC SPINAL-CORD INJURY IN SWEDEN, 1980-1991

Objective: To evaluate the incidence of delivery in women after a trau matic spinal cord injury and to describe pregnancy outcome in this gro up of patients. Methods: Between 1980-1991, 29 women with a traumatic spinal cord injury experienced 49 pregnancies and gave birth to 52 chi ldren in Sweden. A retrospective chart review of the antepartum, intra partum, and perinatal records of these patients was performed. In addi tion, all patients participated in a telephone interview held by one o f the authors. Of the 29 women, 12 had lesions above T5 and 17 had les ions at T5 or below. Results: Antenatal complications occurred frequen tly in this group. Nine of 12 patients with lesions above T5 had sympt oms of autonomic hyperreflexia during pregnancy and/or delivery. Only in a minority of the women was the problem recognized by the medical p rofessionals. Nine of the infants (19%) were born preterm and two were small for gestational age. The perinatal mortality rate was two of 52 (3.8%) and occurred in two cases of abruptio placentae. Few of the pa tients were allowed to deliver vaginally. The cesarean delivery rate f or women with lesions above T5 was 47% and for women with lesions belo w that level, 26%. Conclusion: The overall prognosis for these women w as favorable. However, women with higher spinal cord lesions would pro bably benefit from referral to centers with a particular interest and expertise in the management of their problems.