P.55 Service evaluation of accidental dural puncture follow-up and outcomes in the Royal Gwent Hospital

Abstract

Introduction: Post-dural puncture headache (PDPH) is among the most common complications of neuraxial obstetric anaesthesia, with symptoms ranging from mild headache to severe impairment. Following reports of maternal death associated with PDPH, [1] Knight M, Kenyon S, Brocklehurst P, et al. (Eds.) MBRRACE-UK. Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12. NPEU University of Oxford 2014. Google Scholar the Royal Gwent Hospital introduced a more stringent protocol for follow up of patients with accidental dural puncture (ADP), in conjunction with the introduction of 18G Tuohy needles as standard, aiming to improve outcomes following ADP. [2] Russell IF. A prospective controlled study of continuous spinal analgesia versus repeat epidural analgesia after accidental dural puncture in labour. Int J Obset Anesth 2012;21:7–16. Google Scholar This service evaluation aims to review our compliance with the new follow-up protocol and review rates and management of PDPH following ADP.