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Methods of Delivery in Pregnant Women with Lumbar Disc Herniation: A Narrative Review of General Management and Case Report

Low back pain is a common complaint during pregnancy, affecting approximately half of pregnant women. However, true disc herniation is extremely rare, and the majority of patients heal without surgery. The purpose of this study was to provide an overview of conservative management strategies and del...

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Detalles Bibliográficos
Autores principales: Paslaru, Francesca Gabriela, Giovani, Andrei, Iancu, George, Panaitescu, Anca, Peltecu, Gheorghe, Gorgan, Radu Mircea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Carol Davila University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803304/
https://www.ncbi.nlm.nih.gov/pubmed/33456600
http://dx.doi.org/10.25122/jml-2020-0166
Descripción
Sumario:Low back pain is a common complaint during pregnancy, affecting approximately half of pregnant women. However, true disc herniation is extremely rare, and the majority of patients heal without surgery. The purpose of this study was to provide an overview of conservative management strategies and delivery modes for pregnant patients suffering from lumbar disc herniation without severe neurologic deficits that would require emergency surgery. We performed a narrative review of the literature using the PubMed database. Thirty-one articles were originally retrieved, out of which 7 met the inclusion criteria, compiling a total of 10 cases of parturient patients with lumbar disc hernia treated conservatively until childbirth. The preferred delivery mode was a Cesarean section, which was performed in 6 out of 10 cases. Two patients developed the cauda equina syndrome, one during a failed induction and the other patient 4 weeks after vacuum extraction. However, the second patient failed to improve after surgery. No patients developed cauda equina syndrome during or after the Cesarean section. Based on limited data, the Cesarean section seems to be preferred compared to vaginal delivery to avoid worsening symptoms and progression to the cauda equina syndrome.