Our worst nightmare is post procedural complication.
A 30 year old lady, Para 1, had a LSCS in another hospital. Then, she presented to us 32 days post partum, very early one morning to the green zone, with right leg weakness since the caesarean section, which was done under spinal anaesthesia. Her husband said that the patient was admitted for prolonged stay post surgery in another hospital. A MRI of the lumbar sacral spine was already performed and it was reported to be normal. The patient was alert, conscious and seated on a wheel chair. The power on the right leg was 2/5. Babinski was up going. Patient was not transferred to the examination couch as it was difficult for her to move.
Not really knowing what to do, a quick consultation was made to the other specialties but unfortunately no conclusive results were made. Patient was then referred to the neuromedical consultant who agreed to see the patient in his clinic on the very same day, even though his clinic was fully booked. Examination in the neuromedical clinic revealed a sensory level much higher than the spinal insertion site. A MRI was ordered.
In what appeared to be a surprise diagnosis, the patient was subsequently referred to the neurosurgical department in HKL for surgery.