Risk Factors for Unintended Dural Puncture in Obstetric Patients: A Retrospective Cohort Study

摘要: BACKGROUND Unintended dural puncture (UDP) is one of the main risks epidural analgesia, with a reported incidence approximately 1.5% among obstetric population. UDP associated maternal adverse outcomes, most frequent outcome being postdural headache (PDPH). Our retrospective cohort study objective was to identify demographic and risk factors that increase unintentional as well describing once has occurred. METHODS We retrospectively reviewed all cases UDPs during attempted vaginal delivery between years 2004 2013 in single Israeli hospital. Each case matched 2 parturients who received analgesia before after performed by same anesthesiologist (control group). Demographic, anesthetic, variables were compared control groups. RESULTS Out 46,668 procedures, 177 documented (0.4%). One hundred seven women (60.5%) developed PDPH, 38 (35.5%) required an blood patch. In multivariate logistic regression, degree cervical dilation centimeters at time insertion increased rate (P < .001). Multiparity PDPH = .004). Women had longer length hospital stay than those without CONCLUSIONS UDP, uncommon complication, factors. Nevertheless, it does not seem be outcomes except for prolonged duration stay.