CURRENT MANAGEMENT OF INADVERTENT DURAL TAPS OCCURRING DURING THE SITING OF EPIDURALS FOR PAIN RELIEF IN LABOR - A SURVEY OF MATERNITY UNITS IN THE UNITED-KINGDOM

A postal survey of all maternity units in the UK was conducted to gain information regarding the management of inadvertent dural taps occurring during the siting of epidurals for pain relief in labour. Of the units surveyed only 58.5% had a written protocol for the management of dural taps. Following their occurrence, 99% of the units resited the epidural and in 22%, the midwives continued to give the top-ups. In only one-third of this latter group was the dose of the top-up reduced. In 46% of the units, patients who had a dural tap were allowed to push in the second stage of labour. As prophylaxis against the development of headache, 70% of the units infused crystalloids into the epidural space, whereas only 8.6% were in favour of an early prophylactic blood patch.