Multiple Risk Factors Analysis of Post-dural Puncture Headache (PDPH) among Parturient Patients Underwent Caesarean Section at Obstetric Hospitals in Somaliland

Abstract

Background Regional anesthesia, particularly spinal technique, is administered during obstetric surgery. The patient and the procedure have risk factors that affect the likelihood of post-dural puncture headaches (PDPH). This study aimed to assess multivariate statistical analyses of risk factors that predict PDPH occurrence in patients who underwent Caesarean section in an obstetrics hospital in Somaliland. Methods A cross-sectional study was designed and conducted in obstetrics-selected hospitals in Somaliland. Four hundred parturient patients were included. Statistical tests included Chi Squire and risk analysis (Odd & Risk relative ratios) and the Receiver Operating Characteristic (ROC) curve was used to analyze sensitive risk factors to predict PDPH occurrence. Results The results revealed that 325 parturient patients (81.25%) developed PDPH while 75 parturient patients (18.75%) didn’t report PDPH; multiple lumbar puncture attempts were significantly associated with an increased risk of PDPH, with a P-value of 0.001 and an odds ratio (OR) of 2.705 (95% CI: 1.588–4.605). The ROC analysis for these attempts showed an area under the curve (AUC) of 62%, indicating that the sensitivity and specificity of lumber puncture attempts (56%, 32%) to predict PDPH. However, other risk factors (Age, PMI, Needle type & size, patient’s position) indicate weak predictive value for PDPH occurrence. Conclusion The study concluded that Lumber puncture attempts were a significant risk factor in predicting PDPH compared to other. However, the other risk factors were reported as weak, sensitive and specificity risk factors to predict PDPH occurrence.