Журнал клинических случаев

Managing Symptomatic Severe Disc Prolapse in Pregnancy with Normal Vaginal Delivery: An MDT Approach

Abstract

Kate Croissant and Sangeeta Pathak

Low back pain is common in pregnancy secondary to the hormonal effects on the musculoskeletal system together with the mechanical strain of the pregnant abdomen. An underlying spinal pathology is rare, with disc prolapse being the most common, affecting 1 in 10,000 pregnant women1. Disc prolapse may cause permanent neural deficit in pregnancy. The complexity of managing such a patient requires a multidisciplinary approach involving the obstetrician, community midwife, physiotherapist, health visitor, General Practitioner (GP), anaesthetist, neonatal and spinal teams as seen in our this case report. The plan of care will involve the management of pain and reduced mobility symptoms, choice of analgesia, the social impact of this in the context of a working woman with dependants, consideration of the risk of Venous Thromboembolism (VTE), the potential need for surgery and the influence that this may have on the mode and timing of delivery.