200 Section - A Case of Femoral Nerve Compression During Twin Pregnancy

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

MH

Myrna Hanna, DO

Resident Physician
Montefiore Einstein
Bronx, New York, United States
Yolanda Pham, MD (she/her/hers)

Resident Physician
Montefiore Einstein
Bronx, New York, United States

Co-Author(s)

CH

Carla Hanna, MD

Resident Physician
Montefiore Einstein/Burke Rehabilitation
New Hyde Park, New York, United States
ML

Michael Lew, DO

Attending Physician
Montefiore Einstein
Bronx, New York, United States

Case Diagnosis: Femoral Neuropathy During Pregnancy

Case Description: A 30-year-old female G1P0 (twin pregnancy) with a history of diabetes was referred from her obstetrician's office for 2 months of left anterior thigh pain that began spontaneously and progressively worsened during pregnancy. The pain was described as worse with standing and biking and better with low-dose gabapentin. She also noted associated numbness and tingling without weakness. Initial imaging ruled out a DVT. Physical examination revealed tenderness to palpation of the left adductor muscles and tendon, full hip range of motion, and a positive femoral stretch test with lateral thigh pain at 20 degrees. Straight leg raise was negative. These findings were suggestive of a femoral neuropathy from compression of the femoral nerve during pregnancy, with a plan for conservative management with physical therapy. A 3-month follow-up was scheduled for electrodiagnostic studies and consideration of trigger point injections to the adductor muscles versus femoral nerve hydrodissection if symptoms persist.

Discussions: Femoral neuropathy during pregnancy is uncommon, with most cases occurring postpartum due to complications of labor that compress or stretch the femoral nerve, such as prolonged hip flexion including lithotomy positioning or spinal anesthesia that limits movement. Femoral neuropathy during pregnancy is moreso attributed to the gradual mechanical compression associated with physiological changes, such as uterine enlargement and altered pelvic mechanics, with increased risk in twin pregnancies. Postpartum, patients typically present with weakness and sensory loss over the anterior thigh; however, during pregnancy, weakness may not always be present.

Conclusions: Femoral neuropathy during pregnancy can make the antepartum period uncomfortable and should be considered early, especially in twin pregnancies and diabetic mothers. Diagnoses are clinical but can be confirmed by EDX. Most patients improve with conservative management, and symptoms frequently resolve postpartum once the mechanical pressure is relieved.