Upper left limb paresis in puerpera after delivery

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DOI:

https://doi.org/10.18616/inova.v13i3.8300

Abstract

Postpartum neuropraxias of the extremities are possible postpartum complications, with an estimated incidence of 0.3-2%. There are some case reports of lower limb paresis after normal vaginal delivery. However, an upper limb neuropraxia after normal vaginal delivery has not been reported so far. This is a case report of a 30-year-old woman, primigravidae and healthy, who visited the obstetric emergency department due to a ruptured bag with the onset of labor (at the gestational age of 35 + 6 weeks). After the normal vaginal delivery, which occurred uneventfully with an hour and fifty of expulsive period, in which the parturient exerted a lot of force on the left upper limb to maintain a comfortable position during delivery. The following day the patient reported paresis, edema ++/++++ and altered sensitivity on the ulnar edge and dorsum of the thumb of the MSE. After orthopedic evaluation with MRI request of the cervical spine, degeneration of C3-C4 and osteophytosis were evident. It was then concluded that it was Stretch Neuropraxia. We opted for a conservative consultation as well as follow-up with an orthopedist. After 2 months, the patient had already partially recovered strength and sensitivity in the MSE and recovered completely after 3 months. In conclusion, upper limb neuropraxia can occur after normal vaginal birth, even without perinatal complications. Stretch neuropraxia in the case presented had a good prognosis.

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Published

2023-12-08