- Blessés Médullaires et Reproduction
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Prise en charge des troubles de la reproduction de la femme blessée médullaire
Management of pregnancy and delivery in spinal cord injured women
Andrologie volume 11, pages 247–252 (2001)
Resume
La grossesse de la femme paraplégique est d’un pronostic favorable sous la condition d’un suivi spécialisé. Les complications sont dominées par la fréquence des infections urinaires, le risque de thrombophlébites, la survenue d’escarres. La gravité est liée au possible déclenchement d’un syndrome d’hyperréflexie autonome dans les lésions supérieures à T6, syndrome qui doit être prévenu par la mise en place d’une analgésie péridurale au début du travail. L’accouchement doit s’envisager par voie basse, parfois aidé sur le plan instrumental (forceps). Les indications de césariennes ne doivent être qu’obstétricales ou lors d’un syndrome d’HRA non jugulable. Le risque d’accouchement prématuré apparaît plus important dans cette population, imposant une surveillance drastique lors du 3° trimestre.
Abstract
The overall outcomes of pregnancies and deliveries in spinal cord injured women are generally favorable. However, several antepartum complications may occur, the most frequent being urinary tract infection. There is also a risk of pressure sores and thrombophlebitis. Autonomic hyperreflexia is a serious problem and a potential danger to spinal cord injured women with neurological levels above T6, particularly during the third trimester and during labor. Autonomic hyperreflexia is generally prevented by continuous epidural anesthesia. Concerning the mode of delivery, most patients are able to deliver vaginally, but forceps are sometimes necessary. Cesarean section must only be performed for obstetric reasons and in cases of intractable autonomic hyperreflexia.
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Communication à la Session SALF-AFU des 6° Journées de la Fédération Française d’Étude de la Reproduction, Lyon, 5–7 septembre 2001
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Labat, J.J., Perrouin-Verbe, B. Prise en charge des troubles de la reproduction de la femme blessée médullaire. Androl. 11, 247–252 (2001). https://doi.org/10.1007/BF03034639
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DOI: https://doi.org/10.1007/BF03034639