Factors Associated With the Onset of Chronic Headaches in Patients Who Received a Blood Patch in Post Partum

Study Overview
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Brief Summary
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The purpose of this study is to identify possible links between conditions for carrying out a blood patch (BP) to treat accidental post dural puncture acute headache (PDPH) in the early post partum period and occurrence of chronic headaches at 1 and 6 months.

Detailed Description
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It is established that accidental dural puncture promotes the onset of chronic headaches in 25 to 60% of cases but the risk factors for the occurrence of this event are not known. To identify those risk factors, the investigators will analyze the initial conditions of the accidental breach, the initial manifestations of the PDPH, the methods of carrying out the BP and the patient data. In this study, the investigators will evaluate (phone questionnaire and score) incidence of chronic headaches at 1 month and 6 months after the realization of a blood patch, incidence of chronic low back pain, impact on daily life, incidence of late recurrences of PDPH, incidence of early and distant complications In case of failure of effectiveness of the first blood patch, the investigators will search for associated factors: patient data, mode of delivery, initial PDPH, conditions for carrying out the BP.

Official Title
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Factors Associated With the Onset of Chronic Headaches in Patients Who Received a Blood Patch, Following an Accidental Dural Puncture During Post Partum Period

Conditions
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Blood Patch, Post-Dural Puncture Headache

Intervention / Treatment
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* Other: Questionnaires


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age greater than or equal to 18 years old, Vaginal delivery or caesarean section with epidural at the Port Royal maternity ward, Collection of non-opposition after oral and written information, Exclusion Criteria: Patient under curatorship or guardianship Not speaking/understanding French BP performed in another indication Benefiting from the AME (state medical aid)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with PDPH after epidural analgesia for labor, requiring BP<br>Patients with PDPH after epidural analgesia for labor, requiring BP | Other: Questionnaires<br>* Questionnaires by phone at 1 and 6 months after inclusion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Description of the conditions of the accidental breach | Data collection of diagnosis of the accidental breach : noted with the needle, intrathecal passage, postpartum positional headaches, intrathecal catheter | Immediately after BloodPatch procedure | 
| Time to onset | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH | Immediately after BloodPatch procedure | 
| Positional | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH | Immediately after BloodPatch procedure | 
| Neck pain | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH | Immediately after BloodPatch procedure | 
| Analog visual scale (AVS) | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH | Immediately after BloodPatch procedure | 
| Neurosensory disorders | Description of the initial manifestations of post dural puncture acute headache (PDPH) : nature of PDPH | Immediately after BloodPatch procedure | 
| Completion time after childbirth | Description of the methods of carrying out the BloodPatch (BP) | Immediately after BloodPatch procedure | 
| Volume injected | Description of the methods of carrying out the BloodPatch (BP) | Immediately after BloodPatch procedure | 
| Height of puncture compared to the initial breach | Description of the methods of carrying out the BloodPatch (BP) | Immediately after BloodPatch procedure | 
| Paresthesias | Description of the methods of carrying out the BloodPatch (BP) | Immediately after BloodPatch procedure | 
| Adverse events | Description of the methods of carrying out the BloodPatch (BP) | Immediately after BloodPatch procedure | 
| Duration of strict decubitus in the immediate afterglow | Description of the methods of carrying out the BloodPatch (BP) | Immediately after BloodPatch procedure | 
| Age | Patient data collection | Immediately after BloodPatch procedure | 
| Height | Patient data collection | Immediately after BloodPatch procedure | 
| Weight | Patient data collection | Immediately after BloodPatch procedure | 
| Parity | Patient data collection | Immediately after BloodPatch procedure | 
| Mode of delivery | Patient data collection | Immediately after BloodPatch procedure | 
| History of headaches or migraines before pregnancy | Patient data collection | Immediately after BloodPatch procedure | 
| Initial treatment (before 1st BP) | Patient data collection NSAIDs and analgesics, sphenopalatine ganglion block, ACTH, caffeine, other | Immediately after BloodPatch procedure | 
| Imaging | Patient data collection | 1 month after last BloodPatch procedure | 
| Lumbar punction | Patient data collection | 1 month after last BloodPatch procedure | 
| Other examinations if performed | Patient data collection | 1 month after last BloodPatch procedure | 
| Complications during the initial postpartum stay | Patient data collection | Immediately after BloodPatch procedure | 
| Analog visual scale (AVS) | Patient data collection - Initial efficacy | Immediately after BloodPatch procedure | 
| Analog visual scale (AVS) | Patient data collection - Initial efficacy | 1 day after BloodPatch procedure | 
| Analog visual scale (AVS) | Patient data collection - Initial efficacy | At exit of the hospital, up to 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with chronic headaches | Score - phone questionnaire | Month 1 | 
| Number of patients with chronic headaches | Score - phone questionnaire | Month 6 | 
| Number of patients with chronic low back pain | Score - phone questionnaire | Month 1 | 
| Number of patients with chronic low back pain | Score - phone questionnaire | Month 6 | 
| Modified Headache Impact Questionnaire (HIT) | Impact on daily life - Phone questionnaire - Headaches : Yes/No Low back pain, never/rarely/from time to time/often/all the time | Month 1 | 
| Modified Headache Impact Questionnaire (HIT) | Impact on daily life - Phone questionnaire - Headaches : Yes/No Low back pain, never/rarely/from time to time/often/all the time | Month 6 | 
| Number of patients with late recurrence of typical post dural puncture acute headache (PDPH) | Score - phone questionnaire | Month 1 | 
| Number of patients with late recurrence of typical post dural puncture acute headache (PDPH) | Score - phone questionnaire | Month 6 | 
| Number of patients who have been rehospitalized | Score - phone questionnaire | Month 1 | 
| Number of patients who have been rehospitalized | Score - phone questionnaire | Month 6 | 
| Number of patients consulted for headaches | Score - phone questionnaire | Month 1 | 
| Number of patients consulted for headaches | Score - phone questionnaire | Month 6 | 
| Number of patients who received complementary treatments | Score - phone questionnaire | Month 1 | 
| Number of patients who received complementary treatments | Score - phone questionnaire | Month 6 | 
| Patient data collection | In case of failure of efficacy of the 1st BP: patient data, mode of delivery, initial Post dural puncture acute headache (PDPH), conditions for carrying out the BP | Month 1 | 
| Patient data collection | In case of failure of efficacy of the 1st BP: patient data, mode of delivery, initial Post dural puncture acute headache (PDPH), conditions for carrying out the BP | Month 6 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post Dural puncture headache, Epidural blood patch, Chronic headache, Epidural analgesia, Obstetric anaesthesia