Cervical spine cord injury in pregnancy. Conservative management of 3 consecutive cases in Ibadan, Nigeria

Abstract

Study design A prospective study of 3 patients with incomplete cervical spinal cord injury in the 3rd trimester of pregnancy. Objectives To determine the effect of spinal cord injury and treatment with Gardner-Wells\' Tong traction on pregnancy, labour and parturition; and ascertain the effectiveness and safety of this conservative form of management in pregnancy. Setting The patients were admitted and managed between September 2002 and May 2004, in the University College Hospital Ibadan, Nigeria - the major referral Centre in neurological diseases for about a quarter to a third of Nigeria\'s population. Methods From the point of admission into our Emergency Unit, data on each patient was documented prospectively until discharge to the out-patient clinic where each of them was followed up at appointed intervals. These data were then analyzed and compared with reports in literature. Results All the patients had good outcome from the conservative management as measured by complete neurological recovery, uneventful pregnancy and normal parturition. They however, seem to be disposed to pre-term labour, without being aware of the labour pains. Conclusion Spinal cord injury in pregnancy could be successfully manage with Gardner-Wells\' Tong traction without deleterious effects on pregnancy and parturition, but appears to induce pre-term labour, associated with regional analgesia for labour pains.
Etude prospecitve de 3 patientes présentant un traumatisme du rachis cervical au cours du 3ème trimestre de la grossesse. Déterminer les effets du traumatisme rachi-médullaire au cours d\'un traitement par traction cervicale de Gardner-Well dutant le travail et l\'accouchement. Les patientes ont été admises entre septembre 2002 et mai 2004 au centre hospitalier et universitaire d\'Ibadan, Nigeria, centre réferent neurochirurgical pour environ le tiers voire la moitié de la population du Nigéria. Les données cliniques et paracliniques ont été recueillies de l\'admission jusqu\'à la sortie et au cours des consultations de contrôle puis analysées par rapport aux observations de la littérature. Tous les patients ont eu une évolution favorable avec le traitement conservateur que nous avons adopté, avec une récupération neurologique complète, une absence d\'événement indésirable lors du travail, de l\'accouchent et des suites de couches.
Keywords: Cervical spinal cord. Gardner-Wells\' Tongs traction. Third trimester gestation

African Journal of Neurological Sciences Vol. 25 (2) 2006: pp. 6-12