The Case

28 year old primiparous woman presented to high-risk obstetric anaesthetic clinic in September 2022 with a history of subacute combined degeneration of the spinal cord (SACD) secondary to recreational nitrous oxide use. She was otherwise well and planned for a normal vaginal delivery. The question to be answered in clinic was whether regional anaesthesia would be safe and appropriate for her in labour. Her clinical progression of SACD is outlined below.