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Published on: June 26, 2018
Spinal cord stimulation in pregnancy and peripartum management and maternal and device outcomes: a retrospective
Mary Daniels1, Emily Standage2, Choopong Luansritisakul3
1Department of Anesthesiology, Mass General Brigham, Boston, MA 02114, USA; Harvard Medical School, USA.
Background:
Peripartum management of spinal cord stimulation is described in selectively reported cases, therefore real-world practice and its failures are poorly characterized.
Methods:
We conducted a retrospective cohort study of patients with a stimulator implanted before the index pregnancy who delivered at two affiliate hospitals (2015-2026); cases were identified by procedure codes, diagnosis codes, and free-text keywords.
Results:
There were eight patients with 12 deliveries (n = 4 vaginal and n = 8 cesarean); neuraxial labor analgesia or neuraxial anesthesia for cesarean delivery was attempted in all, with reportedly successful block achieved in 10 cases. Both failures occurred in emergencies; one had two successful neuraxial procedures in subsequent deliveries. No unintended dural puncture, new neurologic deficit, local anesthetic systemic toxicity, intensive care unit admission, or device complication occurred. Intrapartum device status was only documented in three of 12 deliveries.
Conclusions:
In this study, the cohort was ascertained systematically, with neuraxial anesthetic failures captured alongside successes. Neuraxial analgesia or anesthesia was attempted in all deliveries, with successful outcomes in most cases. Peripartum device management was inconsistently documented.
