November 2016 · Volume 5 · Issue 11 Page 4067
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Arya S et al. Int J Reprod Contracept Obstet Gynecol. 2016 Nov;5(11):4067-4069
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Case Report
Disc prolapse in pregnancy
Sangeeta Arya, Nidhi Tripathi, Amrita Singh*
INTRODUCTION
A prolapsed (herniated) disc occurs when the outer fibres
of the intervertebral disc (its annulus) are injured and soft
material known as nucleus pulposus, ruptures out of its
enclosed space. The prolapsed or ruptured disc material
can enter the spinal canal, compressing the spinal cord,
but more frequently spinal nerve, most common in young
and middle aged adults. Pregnancy in some way
predisposes to the development of a lumbar disc
protrusion.
1
Most commonly occur in the lumbar spine and cervical
spine, less commonly, they occur in thoracic spine.
CASE REPORT
A 26 old female presented in our antenatal clinic in first
trimester with complains of back pain, which was
insidious in onset dating back to 3-4 months prior to
conception. Intermittent in nature, radiating to left side of
gluteal region and thigh, responding to analgesics. Along
with analgesics, patient was advised physiotherapy and
other chiropractic measures from our side. However pain
persisted and increased in intensity with advancing
gestation. At 37 completed weeks, patient was planned
for elective cesarean section because of this backache in
order to prevent her from subjecting to cumbersome
lithotomy position during labour. She underwent
uneventful cesarean delivery with a healthy male child.
On her 2
nd
post-operative day when patient was asked to
ambulate, she again had backache which was now more
severe in intensity, radiating to whole of left side of lower
body since her 5
th
post-operative day, patient developed
weakness in her left side of lower body. Her orthopedic
reference was done and patient was advised X-Ray Pelvis
and MRI of spine. X-Ray was normal however MRI was
suggestive of disc prolapse at L5-S1 level patient was
discharged from our side on 8
th
post-operative day for
further management of her disc prolapse.
She was operated for the same-procedure was micro
diskectomy under general anaesthesia and was discharged
on next day of procedure. Thereafter patient had drastic
pain relief and can move better.
Department of Obstetrics and Gynaecology, GSVM Medical College, Kanpur, Uttar Pradesh, India
Received: 23 August 2016
Revised: 30 September 2016
Accepted: 01 October 2016
*Correspondence:
Dr. Singh Amrita,
E-mail: amritanitinshankar@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Surgery is required only in about 1 in 10 cases of slipped disc. It may be considered if there is evidence of severe
nerve compression, symptoms not improved using other treatments, having difficulty in standing or walking, have
severe symptoms such as progressive muscle, weakness or altered bladder function. A microdiscectomy is typically
performed for a herniated lumbar disc and is actually more effective for treating leg pain (also known as
radiculopathy) than lower back pain. Impingement on the nerve root (compression) can cause substantial leg pain.
While it may take weeks or months for the nerve root to fully heal and any numbness or weakness to get better,
patients normally feel relief from leg pain almost immediately after a microdiscectomy spine surgery. Backache
during pregnancy must not be overlooked as only minor ailment due to mechanical stress. Patient should be
investigated on lines of spinal pathology.
Keywords: Disc prolapse, Pregnancy, Backache, MRI spine
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20163892