Overt and Covert Postpartum Urinary Retention, Risk Factors and Complications

Zalina Nusee,Aimi Rahayu A Rashid,Nurul Hikmah Mohamed Nor,Hamizah Ismail,Hasliza Zakaria

doi:10.24018/ejmed.2020.2.4.391

Zalina Nusee, Aimi Rahayu A Rashid + Show 3 more

Open Access

https://doi.org/10.24018/ejmed.2020.2.4.391

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Abstract

Background: The overall risk of postpartum urinary retention (PUR) is between 0.05% and 37%. Being Asian increases the risk, while other factors include epidural analgesia, prolonged first and second stage of labour and previous history of PUR. Subjects and Methods: This is a cohort study conducted at a tertiary hospital in Pahang State of Malaysia over one year duration. All postpartum women were included. The post void residual volume (PVRV) was measured after minimum 6 hours postpartum or when the subject complained of inability to pass urine. The PVRV of more than 150ml was considered as PUR. Data analysis was performed using SPSS version 20. Results: Of 1000 included women, mean age was 28.44(5.68), parity of 2.0 and 75.8% had vaginal delivery. PUR was diagnosed in 42 (4.2%) women, of whom 4 (9.5%) were diagnosed with overt and 38 (90.5%) had covert PUR. Parity and perineal tear were significantly associated with PUR. Second degree perineal tear (including episiotomy) were independent risk factors associated with PUR (adjusted OR 3.19, CI 1.23 - 8.30). Conclusion: Incidence of PUR in our population is low compared with others. Second degree perineal tear (including episiotomy) is a risk factor for PUR. PUR screening is not needed in our population.

Highlights

Postpartum urinary retention (PUR) can be described as inability to pass urine at six hours postpartum
Second degree perineal tear were independent risk factors associated with PUR
Incidence of PUR in our population is low compared with others

Summary

Introduction

Postpartum urinary retention (PUR) can be described as inability to pass urine at six hours postpartum. In 1997, a distinction between two types of PUR was made [3] and had since used widely in the literature. PUR is divided into two categories, overt and covert PUR. Women who fall into overt PUR category are those who are unable to micturate spontaneously within 6 hours postpartum or 6 hours after removal of indwelling catheter, with post void residual volume (PVRV) of more than 150ml. This is deemed as symptomatic urinary retention. Covert PUR can only be detected by ultrasound or by catheterisation after spontaneous micturition, when the PVRV is more than 150 ml

Results

Discussion

Conclusion