Prevalence and Predictors of Post-Dural Puncture Headache (PDPH) in a Sample of Pregnant Women Who Underwent Cesarean Delivery under Spinal Anaesthesia in the United Arab Emirates

Background: Spinal anaesthesia is the most used anaesthesia technique for Caesarean delivery with 80%-95% prevalence.The most common complication of Spinal anaesthesia is post-dural puncture Headache which is associated with dural puncture and Cerebrospinal fluid leak.Objective: To identify prevalence and predictors of post-dural puncture headache (PDPH) in pregnant women undergoing caesarean delivery under spinal anaesthesia. Methods:We conducted a retrospective review of 132 pregnant women who received spinal anaesthesia for caesarean section (CS).Demographic, obstetric, and procedural variables were collected.Univariate and multivariate logistic regression analyses were performed using IBM SPSS v20 to determine odds ratios (OR) and 95% confidence intervals (CI); significance was set at p 0.05.Results: PDPH occurred in 50% of cases.In univariate analysis, sitting puncture position (OR 3.75; 95% CI 1.78-7.88;p < 0.001), two or more dural puncture attempts (OR 30.18;; p < 0.001), and needle gauge 25 G or less (OR 130.64;; p < 0.001) were significantly associated with PDPH.Multivariate logistic regression analysis identified needle gauge 25 G as the sole independent predictor of PDPH (OR 144.95;266.71;p < 0.001). Conclusion:Needle gauge and number of attempts and sitting puncture position are strong, modifiable risk factors for PDPH.Adoption of larger-gauge, atraumatic needles, lateral decubitus puncture position and minimizing puncture attempts may reduce PDPH incidence in obstetric spinal anaesthesia.