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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Motor deficit in the puerperium. Is neuraxial analgesia the most frequent cause?
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Vol. 67. Issue 4.
Pages 215-218 (April 2020)
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Vol. 67. Issue 4.
Pages 215-218 (April 2020)
Case report
Motor deficit in the puerperium. Is neuraxial analgesia the most frequent cause?
Déficit motor en el puerperio. ¿Es la analgesia neuroaxial la causa más frecuente?
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N. Fuertes Sáeza,
Corresponding author
Neusfuer@gmail.com

Corresponding author.
, I. Giménez Jiméneza, M. Batista Doménecha, F. Montero Sáncheza, I. Elia Martínezb, P. Argente Navarroa
a Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, Spain
b Servicio de Radiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Abstract

Motor deficits of lower limbs during pregnancy and the puerperium are relatively frequent. They are usually attributed to complications which are associated with neuraxial techniques performed by the anaesthesiologist. But there are other possible causes, such as transient osteoporosis of the hips.

Transient osteoporosis of pregnancy is a rare and self-limited pathology of unknown aetiology. The most severe complication that can occur are pathological fractures, mainly in the load joints. This pathology usually occurs in the third trimester of pregnancy and is showed up with pain and functional impotence of the lower limb affected.

We present the case of a 35-year-old woman, 40+3 weeks of pregnancy who starts labour. Normally functioning epidural catheter is placed and finally caesarean section is decided because failure to progress; 48h later the patient begins with functional impotence and pain in the lower left limb. MRI is performed, epidural haematoma is ruled out and osteopenia of the hips is proved. The patient is diagnosed with transient osteoporosis of pregnancy.

Keywords:
Motor deficit
Hip osteopenia
Puerperium
Neuraxial anaesthesia
Resumen

Los déficits motores de miembros inferiores durante el embarazo y el puerperio son relativamente frecuentes. Se atribuyen habitualmente a complicaciones asociadas a las técnicas neuroaxiales que son realizadas por el anestesiólogo. Pero existen otras posibles causas, como la osteoporosis transitoria de caderas.

La osteoporosis transitoria del embarazo es una patología infrecuente y autolimitada de origen desconocido. La complicación más severa que puede presentar son las fracturas patológicas, fundamentalmente en las articulaciones de carga. Esta patología suele presentarse en el tercer trimestre del embarazo y cursa con dolor e impotencia funcional del miembro inferior afecto.

Presentamos el caso de una mujer de 35 años, gestante de 40+3 semanas que inicia trabajo de parto. Se coloca catéter epidural normofuncionante y finalmente se decide cesárea por parto estacionado; 48h después comienza con impotencia funcional en miembro inferior izquierdo y dolor. Se realiza RM donde se descarta haematoma epidural y se objetiva osteopenia de caderas, siendo diagnosticada de osteoporosis transitoria el embarazo.

Palabras clave:
Déficit motor
Osteopenia de caderas
Puerperio
Anestesia neuroaxial

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