Anesthetic and Obstetric Neurologic Complications of Pregnancy

Neurologic complications in the parturient related to both obstetrics or anesthesia are rare. Women who do not receive neuraxial anesthesia may also present with neurologic complaints. Risk is difficult to calculate due to inaccurate diagnosis, incomplete follow-up (due to resolution of symptoms after hospital discharge), lack of statistical power to assess rare outcomes, and inconsistency of skills of obstetricians and anesthesiologists. Bias also exists as women who received neuraxial techniques are more likely to have neurologic symptoms reported and investigated. Due to the performance of a neuraxial technique, the anesthesiologist is often the first physician contacted for assessment of the patient with such complaints, regardless of the cause of the deficit. Knowledge of risks and possible neurologic complications of anesthetic techniques, as well as other neuropathies related to pregnancy, labor, and delivery, is therefore very important. Anesthesiologists practicing obstetric anesthesia should be able to assess a patient with neurologic deficits and differentiate between obstetric- and anesthetic-related injuries to facilitate immediate diagnosis and treatment of complications that might lead to permanent sequelae.