///2010 Abstract Details
2010 Abstract Details2018-05-01T17:52:49+00:00

Post-dural puncture headache incidence is not exaggerated in parturients with history of headache disorders

Abstract Number: 72
Abstract Type: Original Research

James C. Eisenach M.D.1 ; Dana Turner M.S.P.H.2; Timothy Houle Ph.D.3

Introduction

Intentional dural puncture, whether from spinal or combined spinal epidural (CSE) techniques, carries a risk of post-dural puncture headache (PDPH), although this is unusual with the use of small, pencil-pointed needles currently in use in obstetrics. Whether women with history of headache disorders are at increased risk for PDPH in current practice is not known.

Methods

A secondary analysis was performed using data from the Pain after Delivery (PAD) study, an international, multicenter observational study examining a range of factors associated with postpartum pain after delivery. Participants who self-reported having either migraine or tension-type headaches, or reported being treated by a doctor for headaches before or during pregnancy were grouped together to make up the headache category.

Results

Of the 2235 participants, 81 (3.6%) reported headache in the 72 hours after delivery. A total of 605 women received spinal or CSE anesthesia (27.1%). Of those who did not receive spinal anesthesia, 3.3% of those without previous headaches and 5.1% of those with previous headaches had headaches in the 72 hours after delivery. Of those who received spinal anesthesia, 4.6% of those without previous headaches and 5.9% of those with previous headaches had headaches in the 72 hours after delivery. Those with previous headaches were 1.69 times (95% CI: 0.79 to 3.59) more likely to have headache in the 72 hours after delivery. Women who received spinal anesthesia were 34% more likely to have headache in the 72 hours after delivery (OR: 1.34; 95% CI: 0.83 to 2.19). Both of these risks for developing headache, as well as the combination of the two were not statistically significant, p > 0.05.

Discussion

Headache within 72 hours of delivery is uncommon, even in women with a past history of headache disorder. Use of spinal or CSE techniques for labor and delivery did not magnify the slight and statistically insignificant difference in acute postpartum headache incidence between women with and women without a history of headache disorder.

PAD Investigators: James Eisenach, Timothy Houle, Ruth Landau, Patricia Lavandhomme, Peter Pan, Richard Smiley

SOAP 2010