Li Sen, Zhang Xiaohong, Liu Yan, Wang Yongli, Zheng Xujuan
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, People's Republic of China.
Medical School, Shenzhen University, Shenzhen, 518060, People's Republic of China.
Int J Gen Med. 2023 Nov 16;16:5333-5341. doi: 10.2147/IJGM.S440161. eCollection 2023.
Early recognition and prompt intervention for overt postpartum urinary retention (PUR) takes on a critical significance when a woman chooses labor epidural analgesia for pain relief. However, there have been rare fewer reports on the incidence and factors influencing overt PUR in women after vaginal delivery with labor epidural analgesia in China. Therefore, this study aimed to investigate the incidence and factors correlated with overt urinary retention in postpartum women undergoing vaginal delivery with labor epidural analgesia.
In total, 462 Chinese postpartum women with labor epidural analgesia and vaginal delivery were recruited in one tertiary hospital in Beijing from Dec. 2020 to Nov. 2021. Factors associated with overt PUR for these women were identified through multivariate logistic regression analysis.
The incidence of overt PUR was obtained as 10.2% among these women after vaginal delivery with labor epidural analgesia. As indicated by the result of univariate analysis, forceps-assisted delivery, lateral episiotomy, perineal pain, and fluid administration in the delivery room were correlated with PUR. The result of the multivariate logistic regression suggested that forceps-assisted delivery (odds ratio [OR]=2.46, 95% confidence interval [CI]: 1.14-5.32, =0.022), lateral episiotomy (OR=4.55, 95% CI: 1.91-10.80, =0.001), and perineal pain (OR=4.23, 95% CI: 2.05-8.73, <0.001) were factors affecting overt PUR for these women.
Postpartum women undergoing vaginal delivery with labor epidural analgesia showed a high incidence of overt PUR, and health-care providers should pay more attention to their postpartum urination status in clinical practice. Effective and timely intervention is strongly recommended to reduce the occurrence of overt PUR for these kinds of postpartum women undergoing vaginal delivery with labor epidural analgesia, such as ones experienced forceps-assisted delivery, lateral episiotomy, and more severe perineal pain.
当女性选择分娩硬膜外镇痛来缓解疼痛时,早期识别并及时干预明显的产后尿潴留(PUR)具有至关重要的意义。然而,在中国,关于阴道分娩并使用分娩硬膜外镇痛的女性中明显PUR的发生率及影响因素的报道较少。因此,本研究旨在调查阴道分娩并使用分娩硬膜外镇痛的产后女性中明显尿潴留的发生率及相关因素。
2020年12月至2021年11月期间,在北京一家三级医院招募了462例采用分娩硬膜外镇痛并经阴道分娩的中国产后女性。通过多因素logistic回归分析确定这些女性明显PUR的相关因素。
在这些采用分娩硬膜外镇痛并经阴道分娩的女性中,明显PUR的发生率为10.2%。单因素分析结果表明,产钳助产、侧切、会阴疼痛和产房补液与PUR相关。多因素logistic回归结果显示,产钳助产(比值比[OR]=2.46,95%置信区间[CI]:1.14-5.32,P=0.022)、侧切(OR=4.55,95%CI:1.91-10.80,P=0.001)和会阴疼痛(OR=4.23,95%CI:2.05-8.73,P<0.001)是影响这些女性明显PUR的因素。
采用分娩硬膜外镇痛并经阴道分娩的产后女性中明显PUR的发生率较高,医护人员在临床实践中应更加关注她们的产后排尿情况。强烈建议进行有效及时的干预,以减少这类采用分娩硬膜外镇痛并经阴道分娩的产后女性中明显PUR的发生,比如经历产钳助产、侧切和会阴疼痛更严重的女性。