Spontaneous spinal epidural hematoma in pregnancy associated with using low molecular weight heparin.

Background: Spontaneous epidural hematoma of the spine occurring in pregnancy is uncommon and may result in permanent damage if not promptly treated. The use of low molecular weight heparin may be a risk factor for this condition.

Case: We describe the case of a woman who presented at 27 weeks of gestation with progressive back pain and leg weakness while being treated with low molecular weight heparin. A magnetic resonance imaging (MRI) examination of the spine revealed an epidural hematoma, which was surgically treated. A cesarean delivery was performed at 36 weeks of gestation.

Conclusion: Spontaneous epidural hematoma of the spine may present in pregnant patients using low molecular weight heparin. The onset of neurologic symptoms and pain in these gravidas should be evaluated with MRI. Expeditious surgery is almost always the best treatment option.