Neurologic complications from regional anesthesia and general anesthesia in obstetric practice

Neurological complications from anesthesia in obstetrics encompass a wide variety of etiologies. The most common complications include peripheral neuropathies, which occur in about 0.3%-2% of all pregnancies. Most peripheral nerve injuries are secondary to obstetric-related causes, usually due to compression from fetal head position, surgical or instrumented deliveries, or from prolonged positioning during the second stage of labor. The lateral femoral cutaneous nerve and the femoral nerve are the most commonly injured nerves. Fortunately, these injuries seldom lead to chronic disability and usually resolve over time. Pathologies involving the central nervous system, on the contrary, are rare but may potentially have catastrophic consequences. Spinal cord damage from needle trauma, epidural or spinal hematomas, and epidural abscesses after neuraxial placement, for example, occur infrequently but can result in permanent disability. Meanwhile, headaches in the postpartum period may present similarly but have a variety of different causes ranging from postdural puncture headaches to more serious pathologies such as cerebral venous sinus thrombosis or subdural hematomas.