Acute compartment syndrome of the lower limb following childbirth: a case report
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(2020) 14:140
CASE REPORT
Open Access
Acute compartment syndrome of the lower limb following childbirth: a case report Sharon Coulton1*, Sally Bourne2, Simon Catliffe2, Roderick Brooks2 and David Jollow3
Abstract Background: Acute compartment syndrome is a limb-threatening and occasionally life-threatening emergency that is rarely reported as a complication following childbirth. Prompt diagnosis is crucial to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors and signs and symptoms of acute compartment syndrome is necessary to prevent long-term complications and amputation. Case presentation: This paper presents a case of a 26-year-old primiparous Sri Lankan woman who developed acute compartment syndrome of the lower right limb following childbirth by cesarean section. Conclusion: Acute compartment syndrome is an important differential diagnosis in the setting of sudden onset of lower limb pain following childbirth. Predisposing factors for its manifestation within an obstetric environment are augmented labor, the lithotomy position, postpartum hemorrhage, hypotension following epidural analgesia, and the use of vasoconstrictive agents. If left undiagnosed and untreated, acute compartment syndrome may cause permanent neurovascular deficit, leading to a poor functional result, tissue ischemia, limb amputation, and rhabdomyolysis. If severe, and in large compartments, it can lead to renal failure and death. Alertness and a high index of clinical suspicion for the possibility of acute compartment syndrome are required to avoid a delay in diagnosis, and intracompartmental pressure measurement can be used to confirm the diagnosis. Keywords: Case report, Acute compartment syndrome, Childbirth, Cesarean, Obstetrics, Postpartum pain
Statement of significance
What is already known
Problem
Alertness and a high index of clinical suspicion are required to avoid delayed diagnosis and permanent neurovascular deficit.
Acute compartment syndrome (ACS) is not currently recognized by midwives and obstetricians as a potential complication that may occur following childbirth. The published literature estimates a prevalence of 2 in 10,000 births [1]; however, its true incidence is unknown.
* Correspondence: [email protected] 1 School of Nursing and Midwifery, Western Sydney University, Sydney, Australia Full list of author information is available at the end of the article
What this report adds
This case report highlights the need for midwives and obstetricians to have an understanding of the signs and symptoms of ACS to prevent delayed diagnosis and its consequences for the postpartum woman.
Background ACS of the limb is a limb-threatening and occasionally life-threatening emergency. It is caused by an increased intracompartmental pressure (ICP) that causes a
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Att
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