Prospective study of Incidence and Risk Factors for Post-Dural Puncture Headache in obstetric women
Keywords:
Caesarean section, Headache Disorders, Post dural puncture headacheAbstract
Introduction: post-dural puncture headache (PDPH) consider the major incidence with the significant consequence specially with anesthesia for lower segment cesarean section (spinal anesthesia), headache is very annoying, and it severely limits their daily activities and causes the mother's dissatisfaction, and in cases that start early, it delays the discharge from the hospital and increases the cost. According to what is now known, the PDPH syndrome is more severe, often lasts longer, and has certain potentially fatal sequelae (cerebral hemorrhage) than is typically recognized or acknowledged. Currently, the important problems for obstetric anesthesia of mother was the post-spinal headache.
Material and Methods: the aimed of this research was to assess the occurring of post dural puncture headache in parturient under spinal anesthesia who had cesarean section also, determine the demographic/ biometric and clinical risk factors. The study design was a prospective cohort study conducted at an Iranian public hospital. The study included 316 pregnant women who had a cesarean section or any other surgery, using the conventional spinal anesthesia approach at Arash Hospital in Tehran city. Study participants will be selected from all patients who have the inclusion criteria using convenience sampling from 1 November 2024.
Findings: 316 pregnant women who participate within current study, 21.5% had incidence of PDPH. A previous history of sinusitis or chronic headache was significantly correlation with PDPH in both the early post-operative period (1–3 days PO, p<0.001) and the total incidence of PDPH (p<0.001). A history of headaches after previous spinal anesthesia was also significantly associated with PDPH in the early post-operative period (1–3 days PO, p<0.001) and total PDPH (p=0.007). Daily tea or coffee consumption showed a significant association with PDPH at 4–7 days PO (p=0.021) but was not statistically significant in total PDPH incidence. Other variables, including age, pre-pregnancy BMI, number of previous cesarean sections, volume of fluids administered during the cesarean, and gestational age, did not show a significant association with PDPH in any of the observed time frames.
Conclusion: Our study revealed in the results the history of sinusitis or chronic headache, with the history of previous post-dural puncture headache, that will be elevate the occurring of PDPH in pregnant women..
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