The effect of second-stage pushing and body mass index on postdural puncture headache.
J Clin Anesth
; 37: 77-81, 2017 Feb.
Article
en En
| MEDLINE
| ID: mdl-28235535
ABSTRACT
STUDY OBJECTIVE:
To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles.DESIGN:
Retrospective cohort.SETTING:
Obstetric ward and operating rooms at a university-affiliated hospital. PATIENTS One hundred ninety parturients who had witnessed dural puncture with 17 or 18 gauge Tuohy needles from 1999-2014.INTERVENTIONS:
Patients were categorized by pushing status and body mass index (kg/m2) nonobese <30, obese 30-39.99, morbidly obese 40-49.99, and super obese ≥50. MEASUREMENTS Headache, number of days of headache, maximum headache score, and epidural blood patch placement. MAINRESULTS:
Compared with women who did not push, women who pushed during labor had increased risk of postdural puncture headache (odds ratio [OR], 2.1 [1.1-4.0]; P=.02), more days of headache (P=.02), and increased epidural blood patch placement (P=.02). Super obese patients were less likely to develop headache compared with nonobese (OR, 0.33 [0.13-0.85]; P=.02), obese (OR, 0.37 [0.14-0.98]; P=.045], and morbidly obese patients (OR, 0.20 [0.05-0.68]; P<.01). In a multivariate logistic regression model, lack of pushing (OR, 0.57 [0.29-1.10]; P=.096) and super obesity (OR, 0.41 [0.16-1.02]; P=.056] were no longer significantly associated with reduced risk of postdural puncture headache.CONCLUSIONS:
Parturients who did not push before delivery and parturients with body mass index ≥50kg/m2 were less likely to develop postdural puncture headache in a univariate analysis. Similar trends were demonstrated in a multivariate model, but were no longer statistically significant.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Punción Espinal
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Obesidad Mórbida
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Parto Obstétrico
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Cefalea Pospunción de la Duramadre
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Anestesia Epidural
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Anestesia Obstétrica
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
J Clin Anesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2017
Tipo del documento:
Article