Background and aims
Spinal cord stimulation (SCS) has been successfully employed to treat severe Raynaud’s Syndrome (RS) unresponsive to conventional therapies.1 It has shown a positive safety profile, with few associated complications.2
Primary RS is more prevalent in women3, but few studies about its safety during pregnancy have been conducted.
This case report describes the pain outcomes and safety profile of SCS in two patients who subsequently became pregnant, maintaining treatment via SCS during that period.

Methods
Two female patients presented with severe cases of RS, complaining of bilateral hand pain, rating 9 and 7 on the Numeric Rating Scale (NRS), respectively, with mild response to conventional therapy. Peripheral ischemic lesions and cyanosis of the fingertips were present. 
They underwent SCS, with gradual withdrawal of chronic pain medication, pain improvement (NRS of 1 and 0, respectively) and improved quality of life, assessed by the Nottingham Health Profile questionnaire.
Both patients maintained SCS during pregnancy and delivery, with serial evaluation of its effectiveness and complications.

Results
No complications related to the SCS were detected in any of the cases. Pain remained controlled during this period and no additional pharmacological therapy was required. The SCS was left functioning during delivery.

Conclusion
SCS implantation is a valuable tool to approach severe RS. In addition to improving patient’s quality of life and pain intensity, it appears to be a safe treatment during pregnancy and delivery. Although no complications occurred in the two cases described, more studies must be conducted regarding SCS during this period.

EFFECTIVENESS AND SAFETY OF SPINAL CORD STIMULATION IN PATIENTS WITH SEVERE RAYNAUD'S SYNDROME DURING PREGNANCY - CASE REPORTS