International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2019
ReviewTreatment of obstetric post-dural puncture headache. Part 1: conservative and pharmacological management.
The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately followed-up. ⋯ Surveys of clinical practice in the UK have revealed significant variation in anaesthetic practice in the management of obstetric post-dural puncture headache. To help provide guidance on treatment, the Obstetric Anaesthetists' Association set up a working group to review the literature and produce evidence-based guidelines for management of obstetric post-dural puncture headache. These guidelines have been condensed into two review articles, the first of which covers conservative and pharmacological treatment.
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The Gerard W. Ostheimer lecture is delivered every year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. The lecture aims to provide the anesthesiologist who provides obstetric anesthesia care with a review of the most relevant articles that were published in the preceding calendar year. This article highlights the literature published in 2017 related to maternal mortality, maternal cardiac arrest, cesarean delivery and labor analgesia.
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Int J Obstet Anesth · May 2019
ReviewTreatment of obstetric post-dural puncture headache. Part 2: epidural blood patch.
The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. Despite suffering long-term headaches, neither woman was adequately followed-up after discharge from hospital. ⋯ These guidelines have been condensed into two review articles. In this second review, the role of an epidural blood patch is discussed using a question and answer format.