EP134 The incidence of accidental dural puncture and post dural puncture headache following labour epidural analgesia

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission <h3>Background and Aims</h3> Accidental Dural Puncture (ADP) is the unintentional rupture of the dura mater. ADP-associated Post-Dural Puncture Headache (PDPH) can cause considerable morbidity. The aim of this retrospective study was to identify the incidence of ADP and PDPH following epidural placement for labour analgesia. <h3>Methods</h3> Cases of ADP and PDPH were identified retrospectively from MN-CMS(The Maternal and New-born Clinical Management System).Further cross reference was undertaken using a written departmental communications book. Analysis of this data was carried out using Microsoft Excel. <h3>Results</h3> Between 1st July and 31st December 2023, 1262 women received an epidural for labour analgesia. ADP was identified in 5 women. Two of these women developed PDPH. The incidence of ADP and ADP-related PDPH were 3.9 and 1.58 per 1000 cases respectively. Six additional cases of PDPH after labour epidural analgesia were identified without having a recognised dural puncture, from a written departmental communications book. The overall incidence of PDPH was therefore 6.3 per 1000 cases. Six women required an epidural blood patch, one woman required a second blood patch. PDPH resolved without blood patch in two women. <h3>Conclusions</h3> The observed incidence of ADP complicating epidural anaesthesia is within published ranges. The incidence of post-dural puncture headache after ADP was lower than anticipated. Interestingly three of the women with documented ADP, showed no signs of PDPH. PDPH occurred in the absence of documented ADP.