PM&R
Volume 1, Issue 11 , Pages 1025-1029 , November 2009

Intrathecal Baclofen Administration During Pregnancy: A Case Series and Focused Clinical Review

  • Christina M. Morton, MD

      Affiliations

    • Departments of Physical Medicine and Rehabilitation and Obstetrics and Gynecology, University of Michigan Medical School, 325 E. Eisenhower Pkwy, Suite 100, Ann Arbor, MI 48108†
    • Corresponding Author InformationAddress correspondence to: C.M.M.
    • ,
  • Joshua Rosenow, MD

      Affiliations

    • Functional Neurosurgery, Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL‡
    • ,
  • Cynthia Wong, MD

      Affiliations

    • Division of Obstetrical Anesthesia, Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL§
    • ,
  • Kristi L. Kirschner, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, RIC Women with Disabilities Center, Northwestern University Feinberg School of Medicine, Chicago, IL

Received 8 April 2009 ,Accepted 22 July 2009.

References 

  1. Delhaas EM, Verhagen J. Pregnancy in a quadriplegic patient treated with continuous intrathecal baclofen infusion to manage her severe spasticity (Case report). Paraplegia. 1992;30:527–528
  2. Muñoz FC, Marco DG, Pérez AV, Camacho MM. Pregnancy outcome in a woman exposed to continuous intrathecal baclofen infusion. Ann Pharmacother. 2000;34:956
  3. Engrand N, Van de Perre P, Vilian G, Benhamou D. Intrathecal baclofen for severe tetanus in a pregnant woman. Eur J Anaesthesiol. 2001;18:261–263
  4. Roberts AG, Graves CR, Konrad PE, et al. Intrathecal baclofen pump implantation during pregnancy. Neurology. 2003;61:1156–1157
  5. Ward RM, Bates BA, Benitz WE, et al. The transfer of drugs and other chemical into human milk. Pediatrics. 2001;108:776–789
  6. Baclofen injection (Drug insert). Minneapolis, MN: Norvartis Pharma AG Basle, Switzerland for Medtronic, Inc; 2002;
  7. Albright AL, Schultz BL. Plasma baclofen levels in children receiving continuous intrathecal baclofen infusion. J Child Neurol. 1999;91:733–736
  8. Koulousakis A, Kuchta J. Intrathecal antispastic drug application with implantable pumps: results of a 10 year follow-up study. Acta Neurochir Suppl. 2007;97:181–184
  9. Gracies JM, Nance P, Elovic E, McGuire J, Simpson DM. Traditional pharmacologic treatments for spasticity (Part II: General and regional treatments). Muscle Nerve Suppl. 1997;6:S92–S120
  10. Kroin JS, Ali A, York M, Penn RD. The distribution of medication along the spinal canal after chronic intrathecal administration. Neurosurgery. 1993;33:226–230
  11. Meadows M. Pregnancy and the drug dilemma (FDA Consumer magazine). Volume 35, Number 3 http://www.fda.gov/fdac/features/2001/301_preg.html#categoriesMay–June 2001;Accessed January 27, 2009
  12. Chang AB. Physiologic changes of pregnancy. In:  Chestnut DH editors. Obstetric Anesthesia Principles and Practice. Philadelphia, PA: Elsevier; 2004;p. 15–36
  13. Moran LR, Almeida PG, Worden S, Huttner KM. Intrauterine baclofen exposure: a multidisciplinary approach. Pediatrics. 2004;114:e267–e269
  14. Ratnayaka BDM, Dhaliwal H, Watkin S. Drug points: neonatal convulsions after withdrawal of baclofen. BMJ. 2001;323:85
  15. Plassat R, Verbe BP, Menei P, Menegalli D, Mathe JF, Richard I. Treatment of spasticity with intrathecal baclofen administration: long-term follow-up, review of 40 patients. Spinal Cord. 2004;42:686–693
  16. Guillaume D, Van Havenburg A, Vloeberghs M, Vidal J, Roeste G. A clinical study of intrathecal baclofen using a programmable pump for intractable spasticity. Arch Phys Med Rehabil. 2005;86:1265–1271
  17. Synchromed II drug infusion system brief summary: ITB therapy for severe spasticity. http://www.medtronic.com/physician/itb/disclosure-brief-summary2.htmlJanuary 2008;Medtronic Inc, 2008. Accessed January 28, 2009
  18. Tarshis J, Zuckerman JE, Katz NP, Segal S, Mushlin PS. Labour pain management in a parturient with an implanted intrathecal pump. Can J Anaesth. 1997;44:1278–1281

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

 A poster was presented at the AAPM&R Assembly in September of 2007. No funding was designated for this study.

PII: S1934-1482(09)00725-4

doi: 10.1016/j.pmrj.2009.07.010

PM&R
Volume 1, Issue 11 , Pages 1025-1029 , November 2009

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