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Intrapartum maternal lumbosacral plexopathy.

Bashar Katirji¹, Asa J Wilbourn, Susan L Scarberry

¹Department of Neurology, University Hospitals of Cleveland, 11100 Euclid Avenue, Bolwell Building, Room 2700, Cleveland, OH 44106-5098, USA. bashar.katirji@uhhs.com

|September 5, 2002

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Intrapartum foot drop, often seen in short women, results from fetal head compression of the lumbosacral trunk during labor. This nerve injury typically involves demyelination and resolves within five months.

Area of Science:

Neurology
Obstetrics
Neurophysiology

Background:

Acute foot drop during labor has unclear mechanisms and prognosis.
Previous theories lack consensus on the causes and expected recovery.

Purpose of the Study:

To investigate the mechanism and prognosis of acute foot drop in women experiencing labor arrest.
To identify clinical and electrophysiological characteristics of intrapartum foot drop.

Main Methods:

Case series of seven women with arrested labor and foot drop.
Clinical examination including muscle strength and sensory testing.
Electrophysiological studies: sensory nerve action potentials (SNAPs) and compound muscle action potentials (CMAPs).
Needle electromyography (EMG) to assess L-5 innervated muscles.

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Main Results:

All patients exhibited weakness in ankle movements and sensory loss in the L-5 dermatome.
Nerve conduction studies showed abnormalities in peroneal and sural nerves.
EMG indicated reduced muscle recruitment and denervation potentials.
Foot drop was associated with short stature or large newborns.

Conclusions:

Intrapartum foot drop is likely caused by lumbosacral trunk compression by the fetal head.
The primary pathology involves demyelination, with complete recovery typically occurring within 5 months.
Short stature is a significant risk factor for this condition.