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Transverse myelitis preexisting in pregnancy

Katherine Abegail P. Galang, MD and Catherine Grace L. Lim, MD, FPOGS
Department of Obstetrics and Gynecology, St. Luke’s Medical Center, Quezon City

Transverse myelitis is an acute inflammatory lesion of the spinal cord resulting in motor, sensory, and autonomic dysfunction. Pregnancy increases risk of complications depending on the level of the spinal cord lesion. Hence, a multidisciplinary approach is needed during prenatal period. This is a case of IB, a 32 year-old primigravid, a known case of Transverse Myelitis, initially seen at ten weeks age of gestation. Prenatal course was managed accordingly. She underwent primary cesarean section for arrest in cervical dilatation at 39 weeks, with an unremarkable post-operative course. There is an increased risk of preventable complications such as recurrent urinary tract infections, anemia, development of decubitus ulcers, premature labor and delivery and autonomic dysreflexia. It is imperative that during the prenatal period, the patient be monitored closely and referred to specialists for further management of these simple to fatal complications.