A Rare Case of SCI in a Pregnant Patient in a Resource Limited Setting

Abstract

Background: Spinal cord injury (SCI) during pregnancy is uncommon and may create complex maternal and fetal management challenges, particularly in resource-limited settings. Potential complications include urinary tract infection, impaired mobility, pressure sores, autonomic dysreflexia, thromboembolism, preterm labour, and difficulties related to delivery planning. Case Presentation: We report the case of a 30-year-old multiparous woman at 16+2 weeks of gestation who sustained a T6 spinal cord injury following an accident. She also had cerebral concussion, threatened abortion, and a right clavicular fracture. After initial stabilization and referral for advanced care, she underwent spinal fixation, clavicle fixation, and colostomy. She was subsequently co-managed by a multidisciplinary team (MDT) including obstetrics and gynaecology, general surgery, orthopaedic surgery, physiotherapy and rehabilitation services, anaesthesia, and social support. Serial antenatal assessment and fetal growth monitoring were performed. At 28 weeks, she received corticosteroids for fetal lung maturation, magnesium sulfate for neuroprotection, and prophylactic low-molecular-weight heparin because of increased thromboembolic risk. Outcome: An elective pre-labour caesarean section was performed at 37 weeks under general anaesthesia. A live female neonate weighing 2.7 kg was delivered with Apgar scores of 9, 9, and 10. The postoperative course was uneventful, and no wound breakdown, pressure sores, or infection were reported up to 42 days postpartum. Conclusion: This case highlights the role of coordinated multidisciplinary care in supporting favourable maternal and neonatal outcomes after spinal cord injury during pregnancy in a resource-limited setting.