Neurological complications following obstetric neuraxial anaesthesia: a four-year United Kingdom population-based study of epidural haematoma and epidural abscess (2014–2017)
Authors' conclusion
Epidural abscess and haematoma were rare complications of obstetric neuraxial anaesthesia in the UK, with most women recovering well, though a minority experienced major morbidity.
Study context
- Population
- Women with epidural haematoma or abscess after obstetric neuraxial anaesthesia in obstetrician-led UK maternity units, January 2014–December 2017
- Participants
- 6 vs 11
- Exposure
- Epidural haematoma vs Epidural abscess
- Epidural haematoman = 6
- Epidural abscessn = 11
- Outcome
- Incidence of epidural haematoma and epidural abscess (per 1,000,000 maternities)
Methodological detailsUK Obstetric Surveillance System, national surveillance
- UK Obstetric Surveillance System
- National surveillance
Main finding
As reported in the abstract
Incidence per 1,000,000 maternities
Observational data: associations, not effects.
Further findings
Presentation
- Haematoma: pain or tenderness
- 3/6
- Haematoma: fever
- 2/6
- Abscess: all presented with pain; tenderness
- 8
- Abscess: fever
- 6
- Abscess: lower limb motor block
- 4
- Diagnosis confirmed by MRI in all cases
Risk factors
- Haematoma: perinatal anticoagulant therapy
- 1/6
- Haematoma: multiple catheter attempts
- 1
- Abscess: aseptic precautions potentially suboptimal
- around 70%
- No immunodeficiency reported
Management
- Haematoma: surgery (antibiotics in 1)
- 2
- Abscess: surgery (antibiotics in 4)
- 6
- Abscess: antibiotics alone
- 3
- Haematoma: expectant management
- two-thirds
- Abscess: expectant management
- 1
Safety
Maternal and neonatal outcomes
- Maternal deaths, ICU admissions, stillbirths, neonatal deaths
- 0
- Major maternal morbidity
- 3
Original publication
Neurological complications following obstetric neuraxial anaesthesia: a four-year United Kingdom population-based study of epidural haematoma and epidural abscess (2014–2017). Int J Obstet Anesth. Published 2 June 2025. doi:10.
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