Maternal Obstetric Palsy

Original Editor - Onigbinde Omotola Adam

Lead Editors  

Introduction

Maternal obstetric palsy or obstetric maternal palsy or obstetric maternal lumbosacral plexopathy refers to an injury to the lumbosacral plexus whose signs and symptoms become evident during labor or after childbirth.

Clinically Relevant Anatomy

The lumbar plexus and sacral plexus, if taken as one entity becomes the lumbosacral plexus, the largest spinal nerve plexus. It consists of nerves originating from spinal segments L1 to S4, lumbar plexus taking its origin from L1 to L4 and sacral plexus from L5 to S4 respectively. Nerves arising from the lumbosacral plexus generally course behind the psoas major, piercing the abdominal wall antero-laterally, then course antero-medially, upon the pelvic rim or iliac crest to enter into the lower limb.

Mechanism of Injury / Pathological Process

The position of the lumbocsacral plexus predisposes it to compression during prolonged labour, especially in some categories of women e.g. short women. Any trauma, or compression or injury to the trunks of the lumbosacral plexus creates clinical signs and symptoms in the mother. Katirji et al. (2002) concluded that intrapartum foot drop occurs mostly in short women and is caused by lumbosacral trunk compression by the fetal head at the pelvic brim primary pathology being predominantly demyelination and recovery is complete in up to 5 months.

Clinical Presentation

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Diagnostic Procedures

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Outcome Measures

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Management / Interventions

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Differential Diagnosis

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Resources

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