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Keywords:

  • autonomic dysreflexia;
  • disablity;
  • pregnancy;
  • spasms;
  • spinal cord injury

Key content

  • Pregnancy exacerbates most problems associated with spinal cord injury (SCI).
  • Diagnosis of labour in women with spinal cord injury above T10 of the spinal cord can be challenging.
  • Women with SCI should aim for a vaginal delivery.
  • Autonomic dysreflexia is life threatening and requires immediate treatment.
  • Early epidural analgesia in labour will reduce the incidence of autonomic dysreflexia.

Learning objectives

  • Antenatal management of women with SCI.
  • Care of a woman in labour.
  • Diagnosis and treatment of autonomic dysreflexia.

Ethical issues

  • Women with chronic SCI are knowledgeable about the management of their disability, at times more than the attending medical personnel. Not listening to them may undermine the confidence they have in their care.
  • Women with SCI are concerned that a spinal or epidural analgesia may cause further injury to their spinal cord.