Managing Spasticity in a Pregnant Woman with Spinal Cord Injury: a Review

Abstract

This paper aims to review the available treatment options for spasticity management that can be used for pregnant women with spinal cord injury (SCI). There are extensive reviews exploring the approach to care for the parturient with SCI. These often include a discussion on common medications used and their potential impact on pregnancy and lactation. However, there are no specific guidelines on managing spasticity in pregnancy. Existing review articles show a low level of evidence for commonly utilized physical interventions in spasticity management. There are several case reports on the use of intrathecal baclofen and focal injections with botulinum neurotoxin during pregnancy. The approach to management should recognize the interaction of pregnancy with secondary complications of SCI. Treatment decisions should be based on severity of spasticity, patient goals, and education of potential risks and benefits of different options with regard to pregnancy, lactation, maternal, and fetal outcomes.