Perinatology.  2018 Jun;29(2):97-100. 10.14734/PN.2018.29.2.97.

Spinal Cord Infarction Following Total Hysterectomy Due to Severe Postpartum Hemorrhage

• Kim SR
• Park JW
• Kim JS

• KMID: 2468556
• DOI: http://doi.org/10.14734/PN.2018.29.2.97

Abstract

Spinal cord infarction (SCI) is a rare but often disastrous disorder caused by various pathologic status. The research reports a 34-year-old woman developed SCI after spinal anesthesia for relieving labor pain and total hysterectomy, due to postpartum hemorrhage. Three times of spinal anesthesia were performed, two for controlling labor pain, which were succeeded and one for cesarean delivery, which was failed. After delivery, she was referred to Dankook University Hospital because of uterine atony. On arrival in the emergency room, the blood pressure decreased to 58/32 mmHg, she had a pulse rate of 144 beats/min. While emergent total hysterectomy was performed, she remained hemodynamically stable and there was no episode of hypotension. Since she complained of immobility and loss of sensations the day after the operation, magnetic resonance imaging was performed and showed ischemic change at central portion of the spinal cord at T8 to L1 level.

Keyword

Infarction; Paraplegia; Postpartum hemorrhage; Spinal cord

MeSH Terms

Adult
Anesthesia, Spinal
Blood Pressure
Emergency Service, Hospital
Female
Heart Rate
Humans
Hypotension
Hysterectomy*
Infarction*
Labor Pain
Magnetic Resonance Imaging
Paraplegia
Postpartum Hemorrhage*
Postpartum Period*
Pregnancy
Research Report
Sensation
Spinal Cord*
Uterine Inertia

Figure

• 

  Fig. 1 (A, B) Sagittal T2-weighted MRI image of the whole spine, showing long segmental signal change of the spinal cord at T8 (arrow in A) to L1 level (arrow in B). (C) Axial T2-weighted MRI image at L11 vertebral level showing marked central T2 prolongation and swelling of the spinal cord (arrow), consistent with acute/subacute ischemia. (D) Axial T2-weighted MRI image at L1-2 vertebral level showing posterior epidural hematoma (arrow). MRI, magnetic resonance imaging.

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