Abstract:
One of the most side effects of spinal anesthesia is PDPH, which typically goes away 1–2
days after the dural puncture and normally goes away on its own or with basic painkillers. Even though it
becomes reason for increased maternal morbidity, there is still a great scarcity of researches, which indicate
factors associated with PDPH in eastern Ethiopia.
Objective: This study aimed to assess prevalence and associated factors of PDPH in cesarean section
patients following spinal anesthesia at Hiwot Fana Comprehensive Specialized University Hospital, Harar,
Eastern Ethiopia from November 20/2024-January 20/2025.
Methodology: An institution based cross sectional studydesign was employed among 291 systematically
selected patients who had cesarean section under spinal anesthesia. Data were collected via standardized
questionnaire. Data were entered into EpiData Version 4.6 and were exported to statistical package for
social scienceversion 26 for analysis. Descriptive analysis was conducted. All variables, with p-value less
than 0.3 in bivariate analysis were included for multivariate logistic regression analysis. Strength of
association was presented by an adjusted odd ratio with 95% confidence interval and statistical significance
was declared at p-value less than 0.05.
Results: a total of 291 (with 97% response rate) data were analyzed. The mean (±SD) age of the respondents
was 26.85 (±6.03) years. More than half of the respondents were urban residents. The parity of more than
half of the mothers were ≤3.The overall prevalence of PDPH 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 PDPH
(AOR = 1.87; 95% CI: 1.08-3.25, p=0.025), the use of large spinal needle size (AOR = 2.25; 95% CI: 1.22-
4.14, p=0.009), and patients who had cesarean sections done by emergency type of operation (AOR = 2.72;
95% CI: 1.28-5.80, p=0.010) have shown statistically significant association with PDPH.
Conclusion and Recommendations: In this study, the prevalence of PDPH was high compared with most
other studies. Factors such as previous history of PDPH, patients who received spinal anesthesia using
bigger spinal needles, and respondents who had cesarean sections done by emergency type of operation
have shown statistically significant association.As a result, the hospital should provide training to medical
practitioners on preventive strategies such as advocating using smaller gauge spinal needles and modify the
required medical equipment for emergency cesarean sections.
