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Sciatic nerve palsy complicating umbilical arterial catheterization.

T F Fok, M H Ha, K W Leung

    European Journal of Pediatrics
    |September 1, 1986
    PubMed
    Summary
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    Umbilical arterial catheterization can lead to sciatic nerve palsy in newborns due to gluteal region necrosis. Scar tissue compression caused this nerve injury, with slow and incomplete recovery observed up to six months.

    Area of Science:

    • Neonatal medicine
    • Pediatric neurology
    • Vascular access procedures

    Background:

    • Umbilical arterial catheterization is a common neonatal intensive care unit procedure.
    • Complications, though rare, can include vascular compromise and nerve injury.
    • Ischaemic necrosis of the gluteal region is a potential, albeit infrequent, complication.

    Observation:

    • A term newborn infant presented with right sciatic nerve palsy.
    • The palsy occurred subsequent to ischaemic necrosis of the gluteal region.
    • The gluteal necrosis followed umbilical arterial catheterization.

    Findings:

    • The sciatic nerve lesion was attributed to entrapment and compression by scar tissue.
    • Scar formation resulted from the initial ischaemic event in the gluteal region.

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  • Nerve recovery was characterized by a slow and incomplete progression up to 6 months post-injury.

    • Implications:

    • Highlights the importance of vigilant monitoring for rare complications following umbilical arterial catheterization.
    • Suggests potential for long-term neurological deficits from iatrogenic nerve injury in neonates.
    • Emphasizes the need for careful surgical or conservative management of scar tissue causing nerve compression.