Pregnancy is full of surprises and sweat twists right from day one till the day of labour. For some, the experience can turn sour with complications relevant to pregnancy. One rare yet important complication of pregnancy is neuropathy which is the complication of compression of nerves during pregnancy and childbirth. The most common peripheral neuropathies are carpal tunnel syndrome, Bell’s palsy, and lower extremity neuropathies. Most of the neuropathies are reversible but feature some associated disabilities or morbidities that can limit the functioning of the person and demands therapies.
Radiculopathy is the compression of the nerves at the point where they enter and exit the spine. If a single nerve is affected it is known as mononeuropathy and if many nerves are affected it is called polyneuropathy.
Causes of Peripheral neuropathy:
There are a number of causes that can cause peripheral neuropathies and it is a little difficult to exactly define their origin. There are three methods through which they are acquired – from environmental toxins, from chronic illness and through infection. Hereditary neuropathies are not common, and idiopathic neuropathies occur with no known cause.
Neuropathies can happen during pregnancy as well, as the pressure of the growing uterus creates compression on the spinal nerves. Generally, the pressure is on the ilio-lingual nerve and the genital femoral nerves that supply the lower abdomen and the structures of the pelvic region. Compression of these pelvic and the abdominal nerves can also cause weakness and tingling in the abdomen and the surrounding muscles.
Peripheral neuropathy after pregnancy can be due to episiotomy or a cut in the vagina during birthing. The affected mother feels problems of numbness and difficulty in urination. Incontinence is common of the nerve that controls the sphincter muscles of the urethra and anus are damaged. If the anal sphincters are affected, then fecal incontinence can happen as well. Women who suffered gestational diabetes are also more prone to develop diabetic neuropathy.
Diagnosing peripheral neuropathy:
The doctor can suspect peripheral neuropathy based on medical history when there are tingling and weakness in particular parts of the body. A neurological examination is performed to confirm the diagnosis. Based on these tests, nerve conduction studies can be performed followed by electromyography.
The best treatment approach for peripheral neuropathy is through medicines. Drugs are ordered to treat pain, but doctors avoid opioids and other powerful painkillers during pregnancy and breastfeeding. Anti-depressants, capsaicin cream and other medicines that are allowed during pregnancy and that are safe for both the mother and the child are prescribed for peripheral neuropathy during pregnancy.
Apart from medications, there are certain non-drug treatments that are proven to be effective against the symptoms. Exercise programs and physical therapies such as transcutaneous nerve stimulation (electricity is passed through the nerves), intravenous infusion of immune globulin and plasma exchange are other noninvasive treatment strategies for peripheral neuropathy during and after pregnancy.
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