Lumbar disc protrusions in pregnancy.
نویسنده
چکیده
The occurence of paralysis of a lower limb of the mother after labour was first described at least 120 years ago (von Basedow, 1838). The condition is uncommon, Beattie (1933) reporting an incidence of less than 1 in 2,500 deliveries. This "maternal obstetrical palsy", as it has been named, has usually been considered to result from injury to the lumbosacral plexus occasioned by the foetal head or obstetric forceps during delivery in cases of disproportion. The hypothesis would seem to have sound foundations when paralysis follows a difficult labour and involves muscles supplied by one of the large nerve trunks passing through the true pelvis. However, doubts as to its adequacy in all cases have been expressed since the hypothesis was first put forward. Thus it is recorded that paralysis may follow an apparently normal labour and it may involve the quadriceps femoris muscle of which the nerve of supply, having no intrapelvic course, cannot be injured either by foetal head or obstetric forceps. In 1944 I described four cases of intervertebral disc protrusion developing during pregnancy or the puerperium and associated with a lower limb weakness of greater or less severity; it was suggested on the basis of these cases that protrusion of a lumbar disc was an aetiological factor in maternal obstetric paralysis. The purpose of the present communication is to review the matter in the light of subsequent experience. In Table I it will be seen that of 1,100 consecutive
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ورودعنوان ژورنال:
- Journal of neurology, neurosurgery, and psychiatry
دوره 23 شماره
صفحات -
تاریخ انتشار 1960