Highlights
- •Postnatal headache may be associated with maternal mortality.
- •The management of obstetric post-dural puncture headache (PDPH) varies considerably.
- •Much of the evidence on obstetric PDPH management is not of high quality.
- •Recommendations for treatment with an epidural blood patch are made.
- •Women experiencing PDPH should be followed-up after hospital discharge.
Abstract
The 2009–12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture
had occurred during insertion of a labour epidural catheter. Despite suffering long-term
headaches, neither woman was adequately followed-up after discharge from hospital.
Death resulted from a cerebral vein thrombosis in one case and a subdural haematoma
in the other. Due to significant variation in the treatment of obstetric post-dural
puncture headache, an Obstetric Anaesthetists’ Association working group was set up
to produce evidence-based guidelines to guide clinicians. These guidelines have been
condensed into two review articles. In this second review, the role of an epidural
blood patch is discussed using a question and answer format.
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Article info
Publication history
Published online: December 21, 2018
Accepted:
December 16,
2018
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
