[CG] Postpartum Sensory Neurological Deficits – management

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  • Assess for associated ‘Red Flags’ (see below) at any time postpartum
  • Sensory symptoms only, at 48 hours postpartum
           follow-up after 3 days by Obstetric/Foundation doctor/GP
  • Persisting sensory symptoms after 5 days postpartum arrange for Neurological referral
  • Inform Anaesthetist if patient has had peripartum epidural/spinal analgesia/anaesthesia
  • Meticulous documentation of events

‘Red Flags’

  • Increasing motor weakness 4 hours after spinal anaesthesia or last epidural top-up of local anaesthetic
  • Radicular pain (shooting/ lancinating pain distributed along the dermatome of a nerve. It may or may not be associated with other neurological features)
  • Urinary retention
  • Urinary/faecal incontinence

Action

  • Contact Anaesthetist immediately
  • Exclude spinal/epidural haematoma/abscess
  • Possible neurosurgical emergency
    consider urgent MRI scan within 6 hours of spinal/ epidural/ combined spinal- epidural procedure.

Last reviewed: 31 January 2021

Next review: 23 November 2025

Author(s): Tom Pettigrew

Approved By: GONEC

Document Id: 500