Document Detail


Post-voiding residual volume in 154 primiparae 3 days after vaginal delivery under epidural anesthesia.
MedLine Citation:
PMID:  18242817     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To use 3-dimensional ultrasonography (3D-US) to determine the frequency of post-voiding residual volume (PVRV) > or =100 mL in primiparae 3 days after receiving epidural anesthesia for vaginal delivery. Potential relationships between day-3 PVRV > or =100 mL and obstetrical-pediatric parameters, especially those possibly implicated in post-obstetrical bladder dysfunction, were examined. STUDY DESIGN: We recruited 154 primiparae who vaginally delivered term singletons following uncomplicated pregnancies in the maternity unit of a French teaching hospital. All women had been systematically catheterized 2-h postpartum to measure precisely the volume of urine retained. On the morning of discharge (day 3), when the patient felt the urge to urinate, her 3D-US pre-voiding bladder volume was determined with BladderScan (BVI-3000), then her spontaneously voided urine was collected to accurately quantify its volume and 3D-US was repeated immediately to evaluate the PVRV. PVRV > or =100 mL on day 3 was considered pathological. RESULT: Among these 154 women, 88 (57%) felt the need to urinate and 97 (63%) had a retained volume > or =500 mL at 2-h postpartum. On day-3 postpartum, the median [range] volumes for the entire cohort were: 426.7 [158-999.7] mL 3D-US-measured pre-voiding, 350 [15-1000] mL collected by spontaneous urination, 82.2 [5.3-433.3] mL 3D-US-determined post-voiding; PVRV exceeded 100 mL for 55 (36%). According to our univariate analysis, no factor considered was able to predict PVRV > or =100 mL on day 3. CONCLUSION: Our observations confirmed the existence of PVRV > or =100 mL on day 3 in more than one-third of these primiparae who delivered vaginally under epidural anesthesia. No obstetrical-pediatric factor could be implicated in this bladder dysfunction. Therefore, we recommend frequent and systematic non-invasive 3D-US monitoring of all postpartum patients at least until day 3 to avoid excessive urine retention.
Authors:
Fabien Demaria; Blandine Boquet; Raphaël Porcher; Jonathan Rosenblatt; Patricia Pedretti; Patrick Raibaut; Gérard Amarenco; Jean-Louis Benifla
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Publication Detail:
Type:  Journal Article     Date:  2008-02-01
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  138     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-09-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  110-3     Citation Subset:  IM    
Affiliation:
Service de Gynécologie-Obstétrique, Hôpital Rothschild, Paris Cedex 12, France. fabien.demaria@trs.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural*
Delivery, Obstetric*
Female
Humans
Parity
Pregnancy
Urinary Catheterization
Urinary Retention / ultrasonography*
Urine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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