A 32-year-old woman, G1, P0, 38-week gestation, complained of bilateral hand numbness and pain for the last 2 weeks.

Hand numbness or paresthesias are the most common presenting symptoms of median neuropathy at the wrist (carpal tunnel syndrome). At an incidence of 3.4% in the United States, this is the most common entrapment mononeuropathy. The median nerve is entrapped at the carpal tunnel of the wrist, a narrow fibroosseous tunnel made up on the sides and floor by carpal bones and on the roof by the transverse carpal ligament. The most common symptoms are wrist, hand, and arm pain associated with hand paresthesias. The pain typically is worse at night, disturbing sleep. The paresthesias are most frequently present in the thumb, index finger, middle finger, and radial half of the ring finger. Nocturnal symptoms are often improved by shaking of the hand. Symptoms may be noted with such activities as driving, typing, or holding a phone. Carpal tunnel syndrome is also a common condition in pregnancy (as in our patient), particularly in the last 3 months of pregnancy.
The incidence of preeclampsia in pregnant women with carpal tunnel syndrome ranges between 9% and 20%.