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足月阴道分娩且未行硬膜外麻醉后产后尿潴留的危险因素。

Risk factors for postpartum urinary retention after vaginal delivery at term without epidural anesthesia.

作者信息

Suzuki Shunji, Kakizaki Erina, Kobayashi Risa, Teshima Satomi

机构信息

a Department of Obstetrics and Gynecology , Japanese Red Cross Katsushika Maternity Hospital , Tokyo , Japan.

出版信息

J Matern Fetal Neonatal Med. 2019 Oct;32(20):3470-3472. doi: 10.1080/14767058.2018.1465559. Epub 2018 May 2.

Abstract

We performed a retrospective case-control study of vaginal delivery at term without epidural anesthesia to identify clinical predictions of postpartum urinary retention (PUR). We reviewed the obstetric records of all singleton vaginal deliveries at Japanese Red Cross, Katsushika Maternity Hospital form January 2016 through December 2017. There were 58 women (2.4%) complicated by PUR and 2391 women without PUR. A multivariate analysis revealed nulliparity, instrumental delivery, and episiotomy as independent risk factors for PUR (nulliparity: adjusted OR 2.39, 95%CI 1.2-4.8,  = 0.01; instrumental delivery: 3.53, 95%CI 1.9-6.7,  < .01, episiotomy: adjusted OR 1.96, 95%CI 1.0-3.8,  = .04). While, urination (or urethral catheterization) within 1 hour before delivery revealed as independent prevention factor for PUR (adjusted OR 0.54, 95%CI 0.30-0.99,  = .048). The risk factors identified in our institute seemed to approximately similar to those observed in the institutes capable of performing epidural anesthesia. In addition, urination just before delivery seemed to be an independent prevention factor for PUR.

摘要

我们进行了一项关于足月无硬膜外麻醉阴道分娩的回顾性病例对照研究,以确定产后尿潴留(PUR)的临床预测因素。我们回顾了日本红十字会葛饰妇产医院2016年1月至2017年12月期间所有单胎阴道分娩的产科记录。有58名妇女(2.4%)并发PUR,2391名妇女未发生PUR。多因素分析显示初产、器械助产和会阴切开术是PUR的独立危险因素(初产:调整后的OR为2.39,95%CI为1.2 - 4.8,P = 0.01;器械助产:3.53,95%CI为1.9 - 6.7,P < 0.01;会阴切开术:调整后的OR为1.96,95%CI为1.0 - 3.8,P = 0.04)。而分娩前1小时内排尿(或导尿)显示为PUR的独立预防因素(调整后的OR为0.54,95%CI为0.30 - 0.99,P = 0.048)。我们研究所确定的危险因素似乎与能够进行硬膜外麻醉的研究所观察到的危险因素大致相似。此外,分娩前排尿似乎是PUR的独立预防因素。

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