Clinical features and prognosis of postpartum lower extremity nerve injury: A four-year single-center experience in Israel

Background

Postpartum lower extremity nerve injury (LENI) is a recognized but often underdiagnosed complication of childbirth, presenting with symptoms ranging from transient sensory disturbances to persistent motor deficits. Although the reported incidence is low, research on the topic remains limited, and no studies to date have examined this phenomenon in the Israeli population.

Methods

A retrospective review was conducted of 531 neurological consultations from the maternity ward at Shamir Medical Center between 2019 and 2022. Cases of suspected LENI – postpartum leg weakness, paresthesia, or difficulty walking - were further analysed. Clinical data, delivery characteristics, and electrophysiological findings were reviewed.

Results

Among 33,404 deliveries during the study period, 23 cases of suspected LENI were identified (0.069 %). Most women (61 %) presented with isolated sensory symptoms, primarily in the distribution of the lateral femoral cutaneous nerve. Nine women (39 %) exhibited motor deficits, predominantly following vaginal deliveries with epidural anaesthesia. In 67 % of motor cases, symptoms affected the right side. While most patients experienced full recovery within weeks, 22 % reported persistent symptoms at follow-up.

Conclusion

LENI is a rare complication of childbirth, generally associated with a favorable prognosis. The observed incidence at Shamir Medical Center was low, possibly reflecting underdiagnosis of milder cases. This is the first study to characterize postpartum LENI in the Israeli population. A prospective study is planned to further elucidate its pathophysiology and risk factors.