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Background and Aims Accidental Dural Puncture (ADP) is the unintentional rupture of the dura mater. ADP-associated Post-Dural Puncture Headache (PDPH) can cause considerable morbidity. The aim of this retrospective study was to identify the incidence of ADP and PDPH following epidural placement for labour analgesia.

Methods Cases of ADP and PDPH were identified retrospectively from MN-CMS(The Maternal and New-born Clinical Management System).Further cross reference was undertaken using a written departmental communications book. Analysis of this data was carried out using Microsoft Excel.

Results Between 1st July and 31st December 2023, 1262 women received an epidural for labour analgesia. ADP was identified in 5 women. Two of these women developed PDPH. The incidence of ADP and ADP-related PDPH were 3.9 and 1.58 per 1000 cases respectively. Six additional cases of PDPH after labour epidural analgesia were identified without having a recognised dural puncture, from a written departmental communications book. The overall incidence of PDPH was therefore 6.3 per 1000 cases. Six women required an epidural blood patch, one woman required a second blood patch. PDPH resolved without blood patch in two women.

Conclusions The observed incidence of ADP complicating epidural anaesthesia is within published ranges. The incidence of post-dural puncture headache after ADP was lower than anticipated. Interestingly three of the women with documented ADP, showed no signs of PDPH. PDPH occurred in the absence of documented ADP.