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经阴道分娩后产后尿潴留:一项病例对照研究中的危险因素评估

Postpartum urinary retention after vaginal delivery: Assessment of risk factors in a case-control study.

作者信息

Cavkaytar Sabri, Kokanalı Mahmut Kuntay, Baylas Ayşegül, Topçu Hasan Onur, Laleli Bergen, Taşçı Yasemin

机构信息

Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Ankara, Turkey.

出版信息

J Turk Ger Gynecol Assoc. 2014 Aug 8;15(3):140-3. doi: 10.5152/jtgga.2014.13102. eCollection 2014.

Abstract

OBJECTIVE

To assess the obstetrics risk factors for postpartum urinary retention after vaginal delivery.

MATERIAL AND METHODS

Of 234 women with a vaginal delivery, 19 (8.1%) women who had postpartum urinary retention were cases, and 215 (91.9%) women who did not were controls. Postpartum urinary retention was defined as the presence of postvoid residual bladder volume ≥150 mL or the inability to void within 6 hours after vaginal delivery. Logistic regression analysis identified risk factors for urinary retention.

RESULTS

Prolonged duration of the second stage of labor (OR=0.46, 95% CI for OR=0.06-3.67, p<0.001), presence of episiotomy (OR=0.07, 95% CI for OR=0.01-0.68, p=0.022) and perineal laceration (OR=97.09, 95% CI for OR=7.93-1188.93, p<0.001), and birth weight of >4000 g for the newborn (OR=0.04, 95% CI for OR=0.01-0.20, p<0.001) were found as independent risk factors for postpartum urinary retention after vaginal delivery.

CONCLUSION

Postpartum urinary retention after vaginal delivery is a relatively common condition. Awareness of risk factors, including prolonged second stage of labor, episiotomy, perineal lacerations, and macrosomic birth, may allow us to take the necessary precautions against this complication.

摘要

目的

评估阴道分娩后产后尿潴留的产科危险因素。

材料与方法

在234例阴道分娩的妇女中,19例(8.1%)发生产后尿潴留的妇女为病例组,215例(91.9%)未发生的妇女为对照组。产后尿潴留定义为产后残余膀胱尿量≥150 mL或阴道分娩后6小时内无法排尿。逻辑回归分析确定了尿潴留的危险因素。

结果

第二产程延长(比值比[OR]=0.46,OR的95%置信区间[CI]=0.06 - 3.67,p<0.001)、会阴切开术(OR=0.07,OR的95% CI=0.01 - 0.68,p=0.022)和会阴裂伤(OR=97.09,OR的95% CI=7.93 - 1188.93,p<0.001)以及新生儿出生体重>4000 g(OR=0.04,OR的95% CI=0.01 - 0.20,p<0.001)被发现是阴道分娩后产后尿潴留的独立危险因素。

结论

阴道分娩后产后尿潴留是一种相对常见的情况。了解包括第二产程延长、会阴切开术、会阴裂伤和巨大儿出生等危险因素,可能使我们能够针对这种并发症采取必要的预防措施。

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