Pattern, Interventions and Outcome of Post-Dural Puncture Headache Among Obstetric Patients in Ibadan

Abstract

Background: Post-dural puncture headache (PDPH) is a complication of dura mater puncture. PDPH poses a problem in postpartum women; hence, there is a need to identify and promptly treat it using highly effective, non-invasive techniques that can be easily implemented in low-resource settings to reduce the burden and associated morbidity.

Objective: To examine the interventions and outcomes of PDPH among women who had a subarachnoid block for obstetric indications at the University College Hospital, Ibadan.

Methods: A prospective, cross-sectional study was conducted among women with a subarachnoid block for obstetric indications. A semi-structured interviewer-administered data collection form was used to assess pain at the onset of the headache and followed up to 72 hours post-treatment.

Results: This study evaluated 26 pregnant women with PDPH. Most respondents (18; 69.2%) were ≥30 years old, had a normal BMI of 11 (42.3%), and 26.9% of the women had a prior history of PDPH. Subarachnoid block was performed by a registrar in 24 (92.3%) women. The majority (22; 84.6%) had only one attempt at dural puncture, all in a sitting position with the 25G-sized spinal needle in 96.2%. The headache was incapacitating in 9 (34.6%) cases and got worse in the upright position in 23 (88.5%) women. 

Conclusion: PDPH is a notorious morbidity in parturients, and steps should be taken to minimise the duration and effects of the condition. Prevention, prompt identification, diagnosis, and proactive treatment are desirable.