PROLONGED PARENTERAL MEPERIDINE ANALGESIA DURING PREGNANCY FOR PAIN FROM AN ABDOMINAL-WALL MESH GRAFT

Background. Although successful pregnancy has been reported in women w ith prosthetic mesh abdominal wall grafts, the complication of severe pain in pregnancy from shearing of the graft has not been described. W e report an unusual case of severe pain in pregnancy caused by abdomin al wall stretching by the enlarging uterus. Pain was controlled with l ong-term intravenous meperidine analgesia. Case: A 21-year-old multigr avida with a previously placed mesh graft for multiple abdominal wall hernias presented at 30 weeks' gestation with severe abdominal pain. M eperidine patient-controlled analgesia at a mean dose of 14.2 mg/kg/da y controlled the symptoms, allowing pregnancy prolongation for 28 days before induction of labor at 34 weeks when fetal lung maturity was co nfirmed. Conclusion: This is the first reported case of the use of hig h-dose patient-controlled parenteral narcotic analgesia in a woman who se abdominal wall mesh graft partially sheared from its attachments. T he patient went on to have a successful vaginal delivery.