This syndrome results from compression of the median nerve and is the most frequent mononeuropathy in pregnancy (Padua, 2010). Symptoms include burning, numbness, or tingling along the inner half of one or both hands. Others are wrist pain and numbness extending into the forearm and sometimes into the shoulder (Katz, 2002). Symptoms are bilateral in 80 percent of gravidas, and 10 percent have evidence for severe denervation (Seror, 1998). Diferential diagnosis includes cer vical radiculopathy of C6-C7 and de Quervain tendonitis. he latter is caused by swelling of the conjoined tendons and their sheaths near the distal radius. Nerve conduction studies may be helpful for clariication (Alfonso, 2010).
In pregnancy, the reported incidence of carpal tunnel syn drome is 7 to 43 percent and varies greatly because the range of symptoms is marked (Meems, 2015; Padua, 2010). Symp tomatic treatment with a splint applied to a slightly lexed wrist during sleep lightens pressure and usually provides relief.
Although symptoms typically are self-limited, occasionally sur gical decompression and corticosteroid injections are necessary (Keith, 2009; Shi, 2011). Symptoms may persist in more than half of patients at 1 year and in a third at 3 years (Padua, 2010).
According to the National Spinal Cord Injury Statistical Center (2017), there are approximately 17,000 new spinal cord injuries each year. he average age is 42 years, and males account for 80 percent of new cases. Cord injury severity determines the short-and long-term prognosis as well as that for pregnancy. For women, many have altered sexual function and transient hypothalamic pituitary hypogonadism. hat said, pregnancy is not uncommon if menstruation resumes (Bughi, 2008). In a review of nearly 2000 women in the National Spinal Cord Injury Database, 2 percent reported pregnancy in the prior 12 months (Iezzoni, 2015).
Gravidas with spinal cord injury have an increased frequency of pregnancy complications that include preterm and low-birth weight neonates. Recent observations in nonpregnant women note that the vaginal microbiota is altered in these women (Pires, 2016). Perhaps related, most have asymptomatic bacteriuria with sporadic symptomatic urinary infections. Bowel dysfunction causes constipation in more than half, and anemia and pressure-necrosis skin lesions are also common.
Two serious and life-threatening events can complicate spinal cord injuries. First, if the cord is transected above T 10' the cough reflex is impaired, respiratory function may be compromised, and pneumonitis from covert aspiration can be serious. Pulmonary function tests are considered to assess this risk, and some women may need ventilatory support in late pregnancy or in labor.