Role of cosyntropin in the management of postpartum post-dural puncture headache: a two-center retrospective cohort study
Authors' conclusion
Our data show no benefits from the use of cosyntropin for preventing or treating postpartum PDPH.
Study context
- Population
- Postpartum patients with unintentional dural puncture, two tertiary-care US university hospitals, November 1999 to May 2017analysed
- Participants
- 253 patients
- Exposure
- Prophylactic or therapeutic IV cosyntropin vs none after unintentional dural puncture
- Prophylactic cosyntropinn = 32
- No prophylactic cosyntropinn = 32reference
- Therapeutic cosyntropinn = 36
- No therapeutic cosyntropinn = 153reference
- Outcome
- Incidence of PDPH (prophylactic analysis); receipt of EBP (therapeutic analysis)
Methodological detailstwo-center
- Two-center
Main finding
As reported in the abstract
Odds ratio (95% CI)P value
Prophylactic cosyntropin vs No prophylactic cosyntropinPDPH
1.37(0.48–3.98)
P = 0.56Therapeutic cosyntropin vs No therapeutic cosyntropinEBP
3.20(1.52–6.74)
P = 0.002Observational data: associations, not effects.
Secondary outcomes
| Outcome | Prophylactic cosyntropin | No prophylactic cosyntropin | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| EBP (prophylactic analysis)Prophylactic cosyntropin vs No prophylactic cosyntropin | 38% | 19% | 2.6 (0.83–8.13) | P = 0.095 | |
| 0.10.31310Odds ratio (log scale) |
Original publication
Role of cosyntropin in the management of postpartum post-dural puncture headache: a two-center retrospective cohort study. Int J Obstet Anesth. Published 3 August 2023. doi:10.
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