Peripartum neurological complications and labor epidural: an anesthesiologist predicament

Abstract Background Dismissing the process of labor, postpartum neurological complications tend to implicate anesthetic interventions as cause, a predicament anesthesiologist mandating utmost periprocedural vigilance. Case presentation Two obstetric patients with no comorbidities received uneventful labor epidurals. They presented rare peripartum complications. Conclusions Unrecognized dural puncture is often retrospective diagnosis made onset symptoms in presumed epidural. Negative aspiration cerebrospinal fluid (CSF) during epidural insertion does not completely rule out puncture. Th can be obscured by initial tenting and tear without loss CSF, followed breach weakened arachnoid maternal efforts (Reynolds Speedy, Anaesthesia 45:120-3, 1990). Obstruction TUOHY l umen clot or ligamentum flavum, preventing CSF flow into needle subarachnoid migration subdurally placed catheter, another cause. Delay management resulting from unrecognized punctures occur.