This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo
Clinical Summary

Subdural haematoma risk higher in women with postdural puncture headache

Takeaway

  • Women who developed a postdural puncture headache after neuraxial anesthesia (epidural or spinal) for childbirth had a small, significant increase in the absolute risk for intracranial subdural haematoma during the first few months postpartum.

Why this matters

  • Headache may develop after hospital discharge.
  • Association with subdural haematoma has not been well studied.
  • Subdural haematoma carries risks for permanent disability and death.

Key results

  • Subdural haematoma rate:
    • 1.5 per 100,000 deliveries in entire cohort.
    • 147 per 100,000 deliveries in subgroup with postdural puncture headache.
  • Postdural puncture headache conferred elevated risk for subdural haematoma:
    • Unadjusted absolute risk increase of 145 cases per 100,000 deliveries (crude OR, 134; P<.001).
    • Adjusted absolute risk increase of 130 per 100,000 deliveries (aOR, 199; P<.001).

Study design

  • Retrospective cohort study using US hospital discharge records from the National Readmission Database for 22,130,815 women and deliveries in 2010-2016.
  • Main outcome: intracranial subdural haematoma in 2-month postpartum period.
  • Funding: McGill University Health Center Department of Anesthesia.

Limitations

  • Causality is unknown.
  • Possible surveillance bias, rare event bias.
  • Potential misclassification of exposure, outcome.
  • Database limitations.

References


YOU MAY ALSO LIKE