Kawasoe Izumi, Kataoka Yaeko
Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan.
Department of Nursing, Aiiku Hospital, Tokyo, Japan.
Jpn J Nurs Sci. 2020 Apr;17(2):e12293. doi: 10.1111/jjns.12293. Epub 2019 Aug 29.
This study aimed to clarify the prevalence and risk factors of postpartum urinary retention after vaginal delivery. It also described the healing process of women who had postpartum urinary retention.
In this case-control study, 77 women who had postpartum urinary retention were matched by age and parity with 385 women as controls. Data were analyzed by conditional logistic regression analysis. Data were collected from the women in the case group regarding their healing process and conditions for urinary retention (overt or covert urinary retention).
The prevalence of postpartum urinary retention was 1.2%. The adjusted odds ratio and the 95% confidence intervals for risk factors were as follows: epidural analgesia 4.72, 95% CI 2.38, 9.39; episiotomy 2.68, 95% CI 1.40, 5.13; length of second stage of labor 1.85, 95% CI 0.98, 3.49; labor augmentation 1.78, 95% CI 0.90, 3.51; instrument delivery 0.96, 95% CI 0.43, 2.17; and Kristeller maneuver 0.93, 95% CI 0.37, 2.37. Among 59 women with overt urinary retention, 29 (49.2%) transitioned to covert urinary retention within 10 days after delivery. More than half of the women were normal within 72 hr, but there were five women whose urinary retention did not resolve 11 days following delivery.
The statistically significant risk factors for postpartum urinary retention were epidural analgesia and episiotomy. Initiatives for the prevention and management of postpartum urinary retention are necessary.
本研究旨在阐明阴道分娩后产后尿潴留的患病率及危险因素。同时描述产后尿潴留女性的康复过程。
在这项病例对照研究中，77例产后尿潴留女性与385例女性作为对照按年龄和胎次进行匹配。采用条件逻辑回归分析对数据进行分析。收集病例组女性关于其康复过程及尿潴留情况（显性或隐性尿潴留）的数据。
产后尿潴留的患病率为1.2%。危险因素的调整比值比及95%置信区间如下：硬膜外镇痛4.72，95%置信区间2.38, 9.39；会阴切开术2.68，95%置信区间1.40, 5.13；第二产程时长1.85，95%置信区间0.98, 3.49；产程加速1.78，95%置信区间0.90, 3.51；器械助产0.96，95%置信区间0.43, 2.17；以及克里斯特勒手法0.93，95%置信区间0.37, 2.37。在59例显性尿潴留女性中，29例（49.2%）在产后10天内转变为隐性尿潴留。超过一半的女性在72小时内恢复正常，但有5例女性在产后11天尿潴留仍未缓解。
产后尿潴留的统计学显著危险因素为硬膜外镇痛和会阴切开术。有必要采取预防和管理产后尿潴留的措施。
