Postpartum Sensory Neurological Deficits (400)
Warning
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- Assess for associated ‘Red Flags’ (see below) at any time postpartum
- Sensory symptoms only, at 48 hours postpartum
follow-up after 3 days by Obstetric/Foundation doctor/GP - Persisting sensory symptoms after 5 days postpartum arrange for Neurological referral
- Inform Anaesthetist if patient has had peripartum epidural/spinal analgesia/anaesthesia
- Meticulous documentation of events
‘Red Flags’
- Increasing motor weakness 4 hours after spinal anaesthesia or last epidural top-up of local anaesthetic
- Radicular pain (shooting/ lancinating pain distributed along the dermatome of a nerve. It may or may not be associated with other neurological features)
- Urinary retention
- Urinary/faecal incontinence
Action
- Contact Anaesthetist immediately
- Exclude spinal/epidural haematoma/abscess
- Possible neurosurgical emergency
consider urgent MRI scan within 6 hours of spinal/ epidural/ combined spinal- epidural procedure.