Pregnancy complicated by chronic spinal cord injury and history of autonomic hyperreflexia

Background: Women with spinal cord injuries are at risk for autonomic hyper reflexia during labor. Case: A 36-year-old woman, gravida 4, para 2, abortus 1, with a spinal cord injury and a positive antibody screen result had had a previous pregnancy complicated by autonomic hyperreflexia during labor. Autonomic hyperreflexi a did not occur during serial amniocenteses and fetal transfusions for isoi mmunization or intrapartum. Conclusion: Intrauterine procedures and vaginal delivery were accomplished without autonomic hyperreflexia in this pregnancy. Intrauterine procedures and vaginal delivery might be done safely in women with histories of autono mic hyperreflexia. (C) 2001 by The American College of Obstetricians and Gy necologists.