Evaluating the Safety of Motor Evoked Potentials During Pregnancy: A Literature Review

Motor Evoked Potentials (MEPs), a vital component of intraoperative neurophysiological monitoring (IONM), are instrumental in preserving motor function during complex neurosurgical procedures. However, their application in pregnant patients presents unique clinical challenges due to concerns about fetal safety, including the potential for uterine contractions and fetal distress. This case series evaluates the safety and feasibility of MEP monitoring in pregnant women undergoing neurosurgical interventions. A targeted literature review identified four peer-reviewed case reports involving pregnant patients who underwent procedures such as craniotomies and spinal tumor resections with intraoperative MEP monitoring. In each case, uterine tone and fetal heart rate were continuously monitored, and stimulation parameters were carefully adjusted. Postoperative outcomes revealed preserved maternal neurological function and no maternal or fetal complications. These findings suggest that with meticulous interdisciplinary planning and optimized monitoring protocols, MEPs can be safely employed in neurosurgical procedures during pregnancy without adverse outcomes.