Department of Obstetrics and Gynecology, University Women's Hospital, Spitalstrasse Basel, Switzerland.
Arch Gynecol Obstet. 2011 Feb;283(2):179-83. doi: 10.1007/s00404-009-1320-9. Epub 2009 Dec 19.
Prolonged first and second stage of labor, isolated prolongation of the second stage, forceps delivery or vacuum extraction, perineal laceration, nulliparity and epidural anesthesia are known risk factors for developing prolonged postpartum urinary retention (PUR). The aim of our study was to analyze number and constellations of these risk factors, in prolonged postpartum urinary retention (PPUR) in our own unit to facilitate the identification of patients at high risk and thus to prevent bladder overdistension by early intervention.
We performed a retrospective analysis of all our cases with PPUR between 2003 and 2008 including variables like age weight, height, body mass index, fetal birth weight and head circumference.
The incidence of PPUR at our institution is low being 0.06%. No woman combined all six risk factors. The majority had five risk factors, all had at least four. An isolated prolonged second stage of labor was common to all patients with PPUR. Five women had an epidural anesthesia, three were nulliparous and only two women delivered spontaneously. All but one woman suffered from perineal tears. Interestingly, fetal head circumference was larger than 36 cm in four of six cases.
In contrast to simple PUR, the prolonged form of PUR could be the result of a cumulative effect of different single risk factors.
第一产程和第二产程延长、第二产程孤立性延长、产钳助产或胎头吸引器助产、会阴裂伤、初产妇和硬膜外麻醉是产后尿潴留（PUR）的已知危险因素。我们的研究目的是分析这些危险因素在我院产后尿潴留（PPUR）中的数量和组合，以便于识别高危患者，从而通过早期干预防止膀胱过度充盈。
我们对 2003 年至 2008 年期间我院所有出现产后尿潴留的病例进行了回顾性分析，包括年龄、体重、身高、体重指数、胎儿出生体重和头围等变量。
我院的产后尿潴留发生率较低，为 0.06%。没有一位女性同时具有所有 6 种危险因素。大多数患者有 5 种危险因素，所有患者至少有 4 种。孤立性第二产程延长是所有产后尿潴留患者的共同表现。5 名妇女接受了硬膜外麻醉，3 名是初产妇，只有 2 名妇女自然分娩。除了 1 名妇女外，所有妇女都有会阴撕裂。有趣的是，4 例中胎儿头围均大于 36cm。
与单纯性 PUR 相比，延长型 PUR 可能是不同单一危险因素累积效应的结果。
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