Prevalence and associated factors of postdural puncture headache in cesarean section patients following spinal anesthesia in a public hospital in Harar, Eastern Ethiopia

Résumé

Post-dural puncture headache is becoming a major health problem around the globe. Even though it becomes the reason for increased maternal morbidity, there is still a great scarcity of research in Eastern Ethiopia. This study aimed to assess the prevalence and associated factors of post-dural puncture headache in patients undergoing cesarean sections following spinal anesthesia at Hiwot Fana Specialized University Hospital. An institution-based cross-sectional study was conducted among 291 patients from November 20/2024, to January 20/2025. An adjusted odds ratio presented the strength of association with a 95% confidence interval, and statistical significance was declared at a p-value less than 0.05. The overall prevalence of post-dural puncture headache in cesarean section patients was 39%. Previous history of spinal anesthesia (AOR = 2.05; 95% CI: 1.16-3.65, p = 0.014), previous history of post-dural puncture headache (AOR = 1.87; 95% CI: 1.08-3.25, p = 0.025), use of large spinal needle size (AOR = 2.25; 95% CI: 1.22-4.14, p = 0.009), and patients who had emergency cesarean sections (AOR = 2.72; 95% CI: 1.28-5.80, p = 0.010) have shown statistically significant associations with post-dural puncture headache. The prevalence of post-dural puncture headache in this study was higher than in most other studies. Factors such as previous history of spinal anesthesia, previous history of post-dural puncture headache, patients who received spinal anesthesia using bigger spinal needles, and respondents who had emergency cesarean sections were found to be significantly associated with post-dural puncture headache. The findings of this study suggest that the healthcare providers should pay special attention to emergency cesarean deliveries for women who have a previous history of spinal anesthesia and post-dural puncture headache, as well as providing smaller-gauge spinal needles and pencil-point needles, would be enormous in reducing post-dural puncture headache in patients undergoing cesarean sections.

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