Nerve lesions in obstetrics and gynaecology

Abstract

Nerves can be preferentially or equally damaged in pregnant or non-pregnant women when compared to men due to various reasons. Nerves affected could be sensory nerves, motor nerves or autonomic nerves. Common clinical features of nerve lesions are paraesthesia, pain, burning sensation, loss of sensation, weakness and wasting. Nerve lesions could cause demyelination or axonal degeneration. Neurophysiological tests that could detect nerve damage are nerve conduction tests and needle electromyography (EMG). Clinical presentation, neurophysiological diagnosis and principles of management of various nerve lesions will be discussed during the presentation. Carpal tunnel syndrome is a common disorder in middle aged females. It can also occur during pregnancy and after childbirth. Ulnar nerve lesion at the elbow, radial nerve lesion and thoracic outlet syndrome could occur at any age. Nerves comprising the brachial plexus could be affectedfollowingmastectomy.Meralgiaparaesthetica is not an uncommon disease causing severe distress to the patients. Peroneal, tibial and sciatic nerve lesions and lumbosacral root lesions could occur after childbirth, Metatarsalgia and tarsal tunnel syndrome couid also be present rarely in certain patients. Postpartum obturator nerve lesion could cause groin pain and weakness of thigh adductors. Guillain-Barre Syndrome and Bell's Palsy could affect pregnant women. It could be concluded that pregnant or non-pregnant women presenting with neurological signs and symptoms could be investigated appropriately and managed accordingly.