Abstract:
Post Dural Puncture Headaches (PDPH) is a known complication of spinal
anesthesia. Pregnant mothers who delivered their babies following spinal
anesthesia especially suffer from this disturbing condition. Objective of this
was to determine the incidence of PDPH among mothers who had
caesarean sections in General hospital Kegalle. A descriptive cross
sectional study was conducted involving all post natal units at General
Hospital (GH), Kegalle. All the mothers who had spinal anesthesia during
caesarean sections over 8 month period were considered as the study
population. A case of PDPH is defined as a mother who complained a new
onset headache following 12 hours gap after performing spinal anesthesia
(onset between 12-48 hours). Two study instruments were used; a data
sheet to extract relevant information from medical records and an
interviewer administered questionnaire to elicit experience of mothers.
Study population consisted of 422 mothers who had spinal anesthesia over
a period of 8 months with a mean age of 30.6 (SD 5.9). Only Fifty seven
(13.5%) reported PDPH. Commonest co-morbidity was neck pain (68.4%)
followed by nausea (49.1%). Among them 21 (36.8%) had past history of
headache. Six (10.5%) mothers with PDPH had pregnancy induced
hypertension while 4 (7.0%) had GDM. Most of them got down from bed
after 6 hours (73.2%). Among those PDPH, majority had spinal anesthesia
with a needle of 24 G (92.8%), and among 95.6%, it was performed by a
medical officer and in most of those instances performing person had an
experience of 1-3 years in anesthesia. Experience less than 1 year was
significantly associated with the development of PDPH (p<0.01).
Prevalence of PPDH was 13.5% and commonest comorbidity was neck
pain. Risk was more with less experienced performers.
