Treatment of obstetric post-dural puncture headache. Part 1: conservative and pharmacological management

Int J Obstet Anesth. 2019 May:38:93-103. doi: 10.1016/j.ijoa.2018.12.006. Epub 2018 Dec 21.

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. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately followed-up. Death resulted from a cerebral vein thrombosis in one case and a subdural haematoma in the other. Surveys of clinical practice in the UK have revealed significant variation in anaesthetic practice in the management of obstetric post-dural puncture headache. To help provide guidance on treatment, the Obstetric Anaesthetists' Association set up a working group to review the literature and produce evidence-based guidelines for management of obstetric post-dural puncture headache. These guidelines have been condensed into two review articles, the first of which covers conservative and pharmacological treatment.

Publication types

  • Review

MeSH terms

  • Analgesia / methods*
  • Bed Rest / methods*
  • Conservative Treatment / methods*
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Post-Dural Puncture Headache / drug therapy
  • Post-Dural Puncture Headache / therapy*
  • Pregnancy
  • Pressure
  • United Kingdom