A 25-year-old female with T4 AIS A SCI asks about her ability to become pregnant. Which response is MOST accurate?

A 25-year-old female with T4 AIS A SCI asks about her ability to become pregnant. Which response is MOST accurate?

• A. Females with SCI cannot become pregnant
• B. Female fertility is significantly and permanently reduced after SCI
• C. Females with SCI generally do not see a decrease in fertility and can become pregnant, carry to term, and deliver, but are at risk for autonomic dysreflexia during labor
• D. Females with SCI can become pregnant but cannot deliver vaginally

Answer: (C)

The key idea is that fertility is typically preserved after spinal cord injury, and a pregnancy can be carried to term with careful obstetric management. In females with SCI, ovulation and conception can occur, so becoming pregnant is possible. The level and completeness of the injury do not usually prevent pregnancy or delivery, but there is a real risk of autonomic dysreflexia during labor for injuries at or above roughly T6, due to disrupted autonomic control below the lesion. For a person with a T4 AIS A injury, this means pregnancy and term delivery are feasible, but labor must be monitored and managed to prevent or treat dysreflexia. Therefore, the statement that best captures reality is that fertility is generally preserved, pregnancy and term delivery are possible, but autonomic dysreflexia during labor is a notable risk.

The key idea is that fertility is typically preserved after spinal cord injury, and a pregnancy can be carried to term with careful obstetric management. In females with SCI, ovulation and conception can occur, so becoming pregnant is possible. The level and completeness of the injury do not usually prevent pregnancy or delivery, but there is a real risk of autonomic dysreflexia during labor for injuries at or above roughly T6, due to disrupted autonomic control below the lesion. For a person with a T4 AIS A injury, this means pregnancy and term delivery are feasible, but labor must be monitored and managed to prevent or treat dysreflexia. Therefore, the statement that best captures reality is that fertility is generally preserved, pregnancy and term delivery are possible, but autonomic dysreflexia during labor is a notable risk.