Acceptable Postvoid Residual Urine Volume after Vaginal Delivery and Its Association with Various Obstetric Parameters.

Wen Sze Choe,Pei Shan Lim,Beng Kwang Ng,Ixora Kamisan Atan

doi:10.1155/2018/5971795

Abstract

Background Urinary retention and voiding dysfunction is a distressing event and relatively common in immediate postpartum period. This study aims at investigating the range of postvoid residual urine volume after vaginal delivery and its association with various obstetric parameters. Methods This was a prospective observational study of women who delivered vaginally in Universiti Kebangsaan Malaysia Medical Centre from March 2017 to September 2017. Those who were able to void within 6 hours after delivery, the voided volume measurements were taken at their second void followed by measurement of residual urine using a transabdominal ultrasound scan. For those unable to void at 6 hours postpartum, the bladder volume was measured. If the bladder volume was 500 ml or more, an indwelling catheter would be inserted and kept for 24 hours. Results A total of 155 patients who fulfilled the inclusion were recruited. There were 143 (92.3%) patients who had residual urine volume of less than 150 ml at second void. Out of these 143 patients, 138 (96.5%) had residual urine volume of less than 100 ml, and among the 138 patients, 119 (86.2%) had residual urine volume of less than 50 ml. The median residual urine volume was 10 ml (2, 42). The overall rate of postpartum urinary retention (PPUR) was 7.7%; 6 (3.85%) had overt retention and 6 (3.85%) had covert retention. Primiparity, duration of active phase of labour, duration of second stage of labour, epidural analgesia, episiotomy, instrumental delivery, and perineal pain score were independent risk factors associated with postpartum urinary retention. Conclusion Postpartum urinary retention complicates approximately 7.7% of vaginal deliveries. Majority (86.2%) of them had residual urine volume less than 50 ml. Obstetrics factors independently associated with PPUR include primiparity, duration of active phase of labour, duration of second stage of labour, epidural analgesia, episiotomy, instrumental delivery, and degree of perineal pain.

Highlights

Urinary retention and voiding dysfunction are distressing events and relatively common in immediate postpartum period
Covert retention refers to women that are asymptomatic of urinary retention, with a postvoid residual bladder volume of more than 150 ml, Obstetrics and Gynecology International identified by ultrasound screening or by catheterization [3, 7, 8]
A total of 163 patients were approached during the study duration, but eight patients declined to participate in the study. us, a total of 155 patients who delivered vaginally at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were recruited (Figure 1). e patients’ median age was 30.0 (27.0, 34.0) years old and body mass index was Patients that delivered vaginally in UKMMC and fulfilled inclusion criteria were recruited Informed consent taken and demographic data collected (n = 155)

Summary

Introduction

Urinary retention and voiding dysfunction are distressing events and relatively common in immediate postpartum period. Ose who were able to void within 6 hours after delivery, the voided volume measurements were taken at their second void followed by measurement of residual urine using a transabdominal ultrasound scan. For those unable to void at 6 hours postpartum, the bladder volume was measured. Primiparity, duration of active phase of labour, duration of second stage of labour, epidural analgesia, episiotomy, instrumental delivery, and perineal pain score were independent risk factors associated with postpartum urinary retention. Obstetrics factors independently associated with PPUR include primiparity, duration of active phase of labour, duration of second stage of labour, epidural analgesia, episiotomy, instrumental delivery, and degree of perineal pain

Objectives

Methods

Results