Descriptive cross-sectional study found 2.4% incidence of PDPH in obstetric patients, suggesting key risk factors impact maternal morbidity.
Background: Post-dural puncture headache (PDPH) remains a frequent iatrogenic complication of neuraxial anesthesia in obstetric patients. Although usually self-limiting, it can delay mobilization, impair mother-infant bonding, and affect quality of life. Understanding its frequency and contributing factors is crucial to improving safety and preventing chronic morbidity. Objective: To determine the incidence, severity, and associated risk factors of post-dural puncture headache among obstetric patients undergoing spinal or epidural anesthesia at Peoples University of Medical & Health Sciences for Women (PUMHS), Shaheed Benazirabad. Methods: A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology, PUMHS, from 21 May 2024 to 20 November 2024. A total of 207 obstetric patients receiving neuraxial anesthesia for delivery were included. Data on age, body-mass index, gestational age, anesthesia type, needle gauge and design, number of puncture attempts, provider level, and accidental dural puncture were collected. PDPH was diagnosed according to International Headache Society criteria. Statistical analysis was performed using SPSS v26, applying descriptive statistics and χ² / t-tests, with p < 0.05 considered significant. Results: PDPH occurred in 2.4 % (5 / 207) patients. The mean VAS pain score among PDPH cases was 6.4 ± 1.1, and mean headache duration 2.8 ± 1.1 days. Significant associations were found with multiple puncture attempts (p = 0.0017) and accidental dural puncture (p = 0.0478). No PDPH occurred in epidural-only blocks. Most patients responded to conservative measures; 40 % required an epidural blood patch. The mean hospital stay was longer in PDPH cases (3.7 ± 1.1 days) compared with non-PDPH (2.9 ± 0.9 days). Conclusion: The low PDPH incidence observed highlights improved procedural safety; however, operator experience and atraumatic needle use remain key preventive strategies. Establishing standardized post-anesthesia surveillance and management protocols can further reduce maternal morbidity in obstetric units.
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Arif et al. (2025) studied this question.