Introduction

Women of childbearing age make up around 5–10% of individuals with spinal cord injury (SCI) and may face unique medical and functional complications during pregnancy, including prolonged hospitalization and increased risk of early rehospitalization due to falls.

Case presentation

Here, we discuss a case of a young ambulatory woman with a lumbar motor incomplete spinal cord injury who underwent successful delivery via cesarean section and the role of the physiatrist in the management of the patient’s antepartum, intrapartum, and postpartum complications. The patient faced significant antepartum challenges secondary to her neurogenic bladder and pelvic floor weakness, resulting in increased use of her manual wheelchair. The physiatry team assisted with the co-development of a multidisciplinary bladder plan for increased urinary frequency and urinary tract infection prevention with the patient’s obstetrics physician (OB). In addition, the physiatry team assisted with the procurement of a new wheelchair suited for the patient’s pregnancy and childcare needs in anticipation of decreased mobility during this time. Regarding intrapartum challenges, the physiatry team worked with the patient and her OB to develop a safe birth plan considering the method of delivery, epidural usage, and the need for pelvic floor therapy before and after childbirth.

Discussion

The patient had a successful cesarean section delivery, with return to independent mobility soon after childbirth. In summary, this case demonstrates that there is a need for a multidisciplinary approach to patients with SCI during pregnancy and that the role of physiatry is critical to optimizing medical and functional outcomes.

中文翻译：

---

理疗师在处理不完全性腰椎 SCI 患者妊娠和分娩过程中的独特挑战方面的作用：病例报告

 介绍

育龄妇女约占脊髓损伤 (SCI) 患者的 5-10%，在怀孕期间可能面临独特的医疗和功能并发症，包括住院时间延长以及因跌倒而导致早期再住院的风险增加。

 案例展示

在此，我们讨论一例患有腰部运动不完全性脊髓损伤的年轻卧床妇女，通过剖腹产成功分娩，以及理疗师在处理患者产前、产中和产后并发症中的作用。该患者因神经源性膀胱和骨盆底无力而面临严重的产前挑战，导致她更多地使用手动轮椅。理疗团队协助患者的产科医生 (OB) 共同制定多学科膀胱计划，以增加尿频和预防尿路感染。此外，由于预计患者在此期间活动能力会下降，理疗团队还协助采购了适合患者怀孕和育儿需求的新轮椅。关于产时挑战，物理治疗团队与患者及其产科医生合作，考虑分娩方法、硬膜外麻醉的使用以及分娩前后盆底治疗的需要，制定安全分娩计划。

 讨论

患者顺利进行了剖腹产手术，产后不久就恢复了独立活动能力。总之，该病例表明，需要对妊娠期 SCI 患者采取多学科治疗方法，并且理疗学的作用对​​于优化医疗和功能结果至关重要。