The management of accidental dural puncture in pregnant women: what does an obstetrician need to know?

Archives of Gynecology and Obstetrics
K M Kuczkowski

Abstract

Post-dural puncture headache (PDPH) also known as spinal (or post-spinal) headache still remains a disabling complication of needle insertion into the subarachnoid space. Pregnant women are at particular risk of dural puncture, and the subsequent headache, because of sex, young age, and the widespread application of regional anesthesia. Accidental dural puncture complicating epidural anesthesia varies in incidence from 0.19 to 4.4%. The incidence of epidural needle-induced PDPH headache in pregnant women has been reported to range 76-85%. The classic symptoms of PDPH consist of photophobia, nausea, vomiting, neck stiffness, tinnitus, diplopia, and dizziness in addition to the often, severe cephalgia. This article reviews the current literature on the pathophysiology, incidence, prevention, and treatment of PDPH in pregnant women.

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Citations

Nov 26, 2015·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Nadav MichaanAriel Many
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Sep 1, 2016·A & a Case Reports·Mark J Lenart, Jeffrey M Carness
Oct 1, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Srdjan Ljubisavljevic
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Oct 2, 2015·Proceedings·Erica N GrantWeike Tao
Nov 26, 2013·The Cochrane Database of Systematic Reviews·Polpun Boonmak, Suhattaya Boonmak

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