[Autonomic hyperreflexia, pregnancy and delivery in para-tetraplegia. The obstetric anesthesiologic viewpoint on a case].

Although still rare, pregnancy and delivery in women with spinal cord injuries is becoming more frequent (Table 2). In 85%-90% of patients with lesions above T6 symptoms of autonomic hyperreflexia (Table 1), especially paroxysmal and excessive increases in arterial blood pressure, may occur. In anaesthetising a 31-year-old paraplegic primigravida with a complete transverse spinal lesion at T4 for an elective caesarean section, no indication of hypertonic cardiovascular dysregulation either intra- or postoperatively was observed after repeated epidural administration of bupivacaine. Distinct intraoperative spasticity of the abdominal wall muscles was, however, not influenced by the dosages selected.