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Links To Postpartum Urinary Retention Identified

Instrument-assisted delivery and regional analgesia are both independently associated with occurrence of clinically overt postpartum urinary retention, United States researchers suggest.

While the condition complicates about one in 200 vaginal deliveries, however, most cases are resolved before women leave hospital, report Michael E. Carley, MD, and colleagues from Mayo Clinic, Rochester, Minnesota.

This retrospective, case-controlled study reviewed women with urinary retention seen at the Mayo Clinic between August 1992 and April 2000.

Study objective was to determine the incidence of clinically overt postpartum urinary retention after vaginal delivery and to examine what maternal, fetal and obstetric factors are linked with the condition.

Fifty-one of 11,332 (0.45 percent) vaginal deliveries during the study period were found to be complicated by the condition.

In 80.4 percent of cases, the problem had been dealt with before the women were released from hospital, these authors report.

As for those women who developed urinary retention, they were more likely than were controls to be primiparous, to have had an instrument-assisted delivery, to have received regional analgesia and to have had a mediolateral episiotomy.

Of these four variables, the researchers found on further analysis (multivariate logistic regression) that only instrument-assisted delivery and regional analgesia were significant independent risk factors for the condition.
Am J Obstet Gynecol 2002;187:430-3. "Factors that are associated with clinically overt postpartum urinary retention after vaginal delivery"

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