Study is registered on ClinicalTrials.gov website: NCT02362828

Medical problem

Post-dural puncture headache is the most common serious complication of accidental dural puncture. It has been estimated that that approximately 10,000 women in the European Union suffer accidental dural puncture annually during epidural analgesia for childbirth. The evidence to support best practice in the management of this complication is minimal and limited to small non randomised studies or case series. The most favoured technique to manage post dural puncture headache is the epidural blood patch Current evidence, from very small case series, suggest success rates of 50-60%, rising to 60-75% with second blood patch.
The reason for success or failure of different management strategies in the management of post dural puncture headache needs to be investigated and described.

Design

This is a prospective, observational, multi–centre, cohort audit of clinical practice.

Inclusion Criteria

All women ≥ 18 years old, who develop classical symptoms of post-dural puncture headache after epidural anaesthesia for labour or for caesarean section.

Exclusion Criteria

Post-dural puncture headache following deliberate dural puncture with a spinal needle in women where there was no observed accidental dural puncture with an epidural needle.

Criteria

Objectives

The aims of EPiMAP Obstetrics are:

  • to identify risk factors for failure of epidural blood patch in the obstetric population for management of post dural puncture headache.
  • to describe European practices in the management of accidental dural puncture in the Obstetric population.