Cesarean section--surgical delivery of the fetus through an abdominal incision--now comprises nearly 32 percent percent of all deliveries in the United States, the Centers for Disease Control reports. Cesarean sections, which are major surgery, increase the risk of complications for both mom and baby compared to vaginal delivery. C-section delivery can lead to leg pain after surgery for several different reasons.
Deep Vein Thrombosis
Deep vein thrombosis, or DVT, is the development of a blood clot in the lower extremity, usually the calf of the leg. Inactivity after major surgery can cause sluggish blood flow to the legs, which also occurs in pregnancy due to the compression of blood vessels from the enlarged uterus. Stagnant blood often develops clots. Symptoms include warmth, redness, pain and swelling at the clot formation site. It may be painful to walk or stand on the leg.
Pulmonary embolism, the main danger of DVT, occurs if part of a clot breaks loose from the blood vessel wall and travels to the lungs, blocking blood flow and decreasing oxygen flow to the heart and other parts of the body. Symptoms of pulmonary embolism--shortness of breath, low blood pressure, dizziness or collapse--indicate a medical emergency that needs immediate attention, according to the University of Virginia Medical Center.
Regional anesthesia, used for the majority of Cesarean sections in the United States, includes spinal and epidural anesthesia, which allow mothers to remain awake and alert during the surgery. Since regional anesthesia is placed into the spine or epidural space to numb the nerves that go to the abdomen and lower extremities, damage to the nerve can occur, anesthesiologist Gareth Kantor, M.D. of Case Western Reserve University explains. Lidocaine, an anesthetic used to numb the nerves, may also cause a temporary irritation called transient neurologic syndrome, which can cause pain for several days after the surgery.
Women undergoing Cesarean section are positioned lying flat on an operating table with a 30 degree left lateral tilt, achieved by placing a blanket or other object under the right hip. Left lateral tilt positioning reduces pressure on the blood vessels that supply oxygen to the placenta and increases oxygen to the fetus. However, prolonged positioning can cause nerve damage to the sciatic nerve, resulting in pain in the left buttock and leg after the surgery, according to the American Association of Neuromuscular and Electrodiagnostic Medicine. The injury generally resolves over six to seven weeks. Removing the material from under the patient after the baby is delivered helps prevent the injury.
- University of Virginia: Pulmonary Embolism
- Centers for Disease Control: Teen Birthrates Up Slightly in 2007
- Case Western Reserve University: Spinal Block During Recent C Section; Gareth Kantor, M.D.
- American Association of Neuromuscular and Electrodiagnostic Medicine: Leg weakness After Cesarean Section