Obstetric anesthesia

Postdural puncture headache in obstetrics

Can J AnaesthPublished Narrative review

Authors' conclusion

Often, the addition of a PDPH is incapacitating.

Study context

Population
Obstetric patients with postdural puncture headache (PDPH)
Outcome
PDPH in obstetrics: pathophysiology, risk factors, diagnosis, outcomes, prevention and treatment
Methodological detailsContinuing Professional Development module
  • Continuing Professional Development module

Main finding

As reported in the abstract

  • PDPH: any headache after dural puncture not better accounted for by another diagnosis
  • Risk factors include young age and female sex; with high neuraxial anaesthesia use, obstetric patients are predisposed
  • Spinal technique with small-gauge pencil-point needle and experienced operator decreases PDPH risk
  • PDPH associated with increased risk of major neurologic complications (subdural hematoma, cerebral venous sinus thrombosis, bacterial meningitis)
  • No pharmacological modality has shown benefit in preventing or treating PDPH
  • Epidural blood patch remains the most effective treatment

Original publication

Postdural puncture headache in obstetrics. Can J Anaesth. Published 22 July 2025. doi:10.1007/s12630-025-03013-2

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