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Wang XQ, Guan LS. Effect of percutaneous electrical stimulation at the Baliao point on preventing postpartum urinary retention after labor analgesia. World J Clin Cases 2024; 12:2758-2764. [PMID: 38899285 PMCID: PMC11185340 DOI: 10.12998/wjcc.v12.i16.2758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Anesthetic drugs used in labor analgesia also paralyze the bladder muscle by blocking the sacral plexus, thereby affecting maternal postpartum spontaneous urination and increasing the risk of postpartum urinary retention (PUR). AIM To analyze the effect of percutaneous electrical stimulation at the Baliao point combined with biofeedback therapy for PUR prevention. METHODS We selected 182 pregnant women who received labor analgesia in obstetrics between June 2022 and December 2023. They were divided into the combined therapy group (transcutaneous electrical stimulation of the Baliao point combined with biofeedback therapy) and the control group (biofeedback therapy alone). The first spontaneous urination time, first postpartum urine volume, bladder residual urine volume, postpartum hemorrhage volume, pre-urination waiting time, PUR incidence, adverse reactions, and the intervention's clinical efficacy were compared between the two groups. RESULTS The first spontaneous urination time after delivery was more delayed (2.92 ± 1.04 h vs 3.61 ± 1.13 h, P < 0.001), with fewer initial postpartum urine (163.54 ± 24.67 mL vs 143.72 ± 23.95 mL, P < 0.001), more residual bladder urine (54.81 ± 10.78 mL vs 65.25 ± 13.52 mL, P < 0.001), more postpartum bleeding (323.15 ± 46.95 mL vs 348.12 ± 45.03 mL, P = 0.001), and longer waiting time for urination (0.94 ± 0.31 min vs 1.29 ± 0.42 min, P < 0.001), in the control group than in the combined therapy group. The control group also had higher PUR incidence (4.65% vs 15.85%, P = 0.016). Both groups had no adverse reactions, but the clinical total efficacy rate of the intervention was significantly higher in the combined therapy group than in the control group (95.35% vs 84.15%, P = 0.016). CONCLUSION Percutaneous electrical stimulation of the Baliao point combined with biofeedback can significantly promote postpartum micturition of parturients with labor analgesia, thereby effectively preventing PUR occurrence.
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Affiliation(s)
- Xiao-Qing Wang
- Department of Obstetrics and Gynecology, Suzhou Ninth Affiliated Hospital of Suzhou University, Suzhou 215200, Jiangsu Province, China
| | - Li-Sha Guan
- Department of Obstetrics and Gynecology, Suzhou Ninth Affiliated Hospital of Suzhou University, Suzhou 215200, Jiangsu Province, China
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Kogner L, Lundborg L, Liu X, Ladfors LV, Ahlberg M, Stephansson O, Sandström A. Duration of the active first stage of labour and severe perineal lacerations and maternal postpartum complications: a population-based cohort study. BJOG 2024; 131:832-842. [PMID: 37840230 DOI: 10.1111/1471-0528.17692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The impact of first stage labour duration on maternal outcomes is sparsely investigated. We aimed to study the association between a longer active first stage and maternal complications in the early postpartum period. DESIGN A population-based cohort study. SETTING Regions of Stockholm and Gotland, Sweden, 2008-2020. POPULATION A cohort of 159 459 term, singleton, vertex pregnancies, stratified by parity groups. METHODS The exposure was active first stage duration, categorised in percentiles. Poisson regression analysis was performed to estimate the adjusted relative risk (aRR) and the 95% confidence interval (95% CI). To investigate the effect of second stage duration on the outcome, mediation analysis was performed. MAIN OUTCOME MEASURES Severe perineal lacerations (third or fourth degree), postpartum infection, urinary retention and haematoma in the birth canal or ruptured sutures. RESULTS The risks of severe perineal laceration, postpartum infection and urinary retention increased with a longer active first stage, both overall and stratified by parity group. The aRR increased with a longer active first stage, using duration of <50th percentile as the reference. In the ≥90th percentile category, the aRR for postpartum infection was 1.64 (95% CI 1.46-1.84) in primiparous women, 2.43 (95% CI 1.98-2.98) in parous women with no previous caesarean delivery (CD) and 2.33 (95% CI 1.65-3.28) in parous women with a previous CD. The proportion mediated by second stage duration was 33.4% to 36.9% for the different outcomes in primiparous women. The risk of haematoma or ruptured sutures did not increased with a longer active first stage. CONCLUSIONS Increasing active first stage duration is associated with maternal complications in the early postpartum period.
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Affiliation(s)
- Lisa Kogner
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
| | - Louise Lundborg
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Xingrong Liu
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Linnea V Ladfors
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Mia Ahlberg
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Sandström
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
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Mohd Yassin NA, Kamarudin M, Hamdan M, Tan PC. Self bladder emptying compared with Foley catheter placement for planned cesarean delivery: a randomized controlled trial. Am J Obstet Gynecol MFM 2024; 6:101308. [PMID: 38336174 DOI: 10.1016/j.ajogmf.2024.101308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND The global cesarean delivery rate is high and continues to increase. A bladder catheter is usually placed for the cesarean delivery because a distended bladder is assumed to be at higher risk of injury during surgery and to compromise surgical field exposure. Preliminary data suggest that self bladder emptying (no catheter) at cesarean delivery may have advantages and be safe. OBJECTIVE This study aimed to compare the effects of self bladder emptying and indwelling Foley bladder catheterization for planned cesarean delivery on the rate of postpartum urinary retention and maternal satisfaction. STUDY DESIGN A randomized controlled trial was conducted in a tertiary university hospital from January 10, 2022 to March 22, 2023. A total of 400 participants scheduled for planned cesarean delivery were randomized: 200 each to self bladder emptying or indwelling Foley catheter. The primary outcomes were postpartum urinary retention (overt and covert) and maternal satisfaction with allocated bladder care. Analyses were performed using t test, Mann-Whitney U test, chi-square test, or Fisher exact test, as appropriate. Logistic regression was used to adjust for differences in characteristics. RESULTS Postpartum urinary retention rates were 1 per 200 (0.6%) and 0 per 200 (P>.99) (a solitary case of covert retention) and maternal satisfaction scores (0-10 visual numerical rating scale), expressed as median (interquartile range) were 9 (8-9.75) and 8 (8-9) (P=.003) in the self bladder emptying and indwelling Foley catheter arms, respectively. Regarding secondary outcomes, time to flatus passage, satisfactory ambulation, urination, satisfactory urination, satisfactory breastfeeding, and postcesarean hospital discharge was quickened in the self bladder emptying group. Pain scores at first urination were decreased and no lower urinary tract symptom was more likely to be reported with self bladder emptying. Surgical field view, operative blood loss, duration of surgery, culture-derived urinary tract infection, postvoid residual volume, and pain score at movement were not different. There was no bladder injury. CONCLUSION Self bladder emptying increased maternal satisfaction without adversely affecting postpartum urinary retention. Recovery was enhanced and urinary symptoms were improved. The surgeon was not impeded at operation. No safety concern was found.
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Affiliation(s)
- Nabilah Arfah Mohd Yassin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Maherah Kamarudin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia..
| | - Mukhri Hamdan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Peng Chiong Tan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Baroutis D, Mantzioros R, Sindos M, Psarris A, Daskalakis G. Persistent Postpartum Urinary Retention: A Case Report and Review of Literature. Cureus 2024; 16:e57956. [PMID: 38738167 PMCID: PMC11083741 DOI: 10.7759/cureus.57956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
This case report describes persistent urinary retention lasting over 30 days postpartum in a 23-year-old primiparous female after an otherwise uncomplicated vaginal delivery at 37 weeks gestation. Notable risk factors present included epidural anesthesia, episiotomy, third-degree perineal laceration, and inability to void spontaneously before leaving the delivery room. Despite initial catheterization draining a large volume, the patient experienced recurrent failed voiding trials requiring ongoing intermittent catheterization during her admission. One month after delivery, voiding trials were finally successful, and she regained normal spontaneous voiding without catheterization. This case highlights persistent postpartum urinary retention (PUR) as an uncommon but potentially serious obstetric complication requiring prompt diagnosis and appropriate management to prevent adverse events and optimize outcomes. Although most cases are self-limited, a high index of suspicion is needed to institute timely treatment with intermittent catheterization given the morbidity associated with sustained bladder overdistension postpartum.
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Affiliation(s)
- Dimitris Baroutis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Rafail Mantzioros
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Michael Sindos
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - Alexandros Psarris
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, GRC
| | - George Daskalakis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, GRC
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Miyamoto K, Komatsu H, Nagata H, Nagira K, Motomura E, Shimizu N, Tanaka A. Prolonged second stage of labor in delivery using epidural analgesia is a risk factor for postpartum urinary retention. J Obstet Gynaecol Res 2024; 50:424-429. [PMID: 38124232 DOI: 10.1111/jog.15867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
AIM To determine the postpartum urinary retention rate and risk factors after delivery using epidural analgesia. METHODS This single-center retrospective study targeted 341 women who gave birth after at least 37 weeks of gestation from April to August 2021; from this cohort, 208 patients were examined. The postpartum urinary retention rate was compared between the no epidural analgesia group (n = 107) and epidural analgesia group (n = 101). Subsequently, risk factors for postpartum urinary retention were investigated in the epidural analgesia group. RESULTS After adjustment by propensity score matching for age, body mass index, being primiparous, and labor induction as covariates, the analysis of the incidence of postpartum urinary retention revealed that the epidural analgesia group exhibited a significantly higher postpartum urinary retention rate than the no epidural analgesia group (30% vs. 11%, p = 0.02). The investigation results regarding risk factors for postpartum urinary retention in the epidural analgesia group obtained through a univariate analysis showed that being primiparous and having a prolonged second stage of labor were significantly correlated with postpartum urinary retention. Multivariate analysis indicated that a prolonged second stage of labor was an independent risk factor for postpartum urinary retention (p = 0.03; odds ratio: 3.18; 95% confidence interval: 1.08-9.77). All patients recovered from postpartum urinary retention by day 4. CONCLUSIONS The postpartum urinary retention rate after delivery using epidural analgesia was 25.7%. In the case of epidural analgesia deliveries, a prolonged second stage of labor was an independent risk factor for postpartum urinary retention.
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Affiliation(s)
- Keisuke Miyamoto
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
- Department of Obstetrics and Gynecology, Asagiri Hospital, Akashi, Japan
| | - Hiroaki Komatsu
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
| | - Hiroki Nagata
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
| | - Kei Nagira
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
| | - Eri Motomura
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan
| | - Natsuko Shimizu
- Department of Obstetrics and Gynecology, Asagiri Hospital, Akashi, Japan
| | - Ayumi Tanaka
- Department of Obstetrics and Gynecology, Asagiri Hospital, Akashi, Japan
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Qin H, Feng J, Wu X. Effects and mechanisms of acupuncture on women related health. Front Med 2024; 18:46-67. [PMID: 38151668 DOI: 10.1007/s11684-023-1051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023]
Abstract
Globally, public health interventions have resulted in a 30-year increase in women's life expectancy. However, women's health has not increased when socioeconomic status is ignored. Women's health has become a major public health concern, for those women from developing countries are still struggling with infectious and labor-related diseases, and their counterparts in developed countries are suffering from physical and psychological disorders. In recent years, complementary and alternative medicine has attracted wide attentions with regards to maintaining women's health. Acupuncture, a crucial component of traditional Chinese medicine, has been used to treat many obstetric and gynecological diseases for thousands of years due to its analgesic and anti-inflammatory effects and its effects on stimulating the sympathetic/parasympathetic nervous system. To fully understand the mechanism through which acupuncture exerts its effects in these diseases would significantly extend the list of available interventions and would allow for more reasonable advice to be given to general practitioners. Therefore, by searching PubMed and CNKI regarding the use of acupuncture in treating obstetric and gynecological diseases, we aimed to summarize the proven evidence of using acupuncture in maintaining women's health by considering both its effectiveness and the underlying mechanisms behind its effects.
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Affiliation(s)
- Huichao Qin
- Department of Reproductive Medicine, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, 150036, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Jiaxing Feng
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Xiaoke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
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Dong SM, Hickman LC. Current opinion: postpartum urinary disorders. Curr Opin Obstet Gynecol 2023; 35:510-516. [PMID: 37807921 DOI: 10.1097/gco.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
PURPOSE OF REVIEW The aim of this study was to describe the common postpartum urinary sequelae including urinary retention and incontinence, and to summarize the management of these conditions. RECENT FINDINGS Despite the high frequency of urinary disorders in obstetrics, screening and management protocols are rarely utilized by providers. Large variation exists in the literature regarding assessment of postpartum urinary retention, values of postvoid residuals and management of indwelling catheters in the immediate postpartum population. Recent expert guidance outlines a strategy for managing this condition.Research also highlights that screening for peripartum urinary incontinence is not a routine practice. The diagnosis is made more challenging by the fact that patients commonly understate and over-normalize their symptoms. Emerging studies have found that pelvic floor muscle training is cost-effective, preventive, and may improve symptoms in the postpartum setting. SUMMARY Increased awareness of urinary disorders in pregnancy and postpartum is imperative for appropriate diagnosis and management. Instituting standardized voiding protocols postpartum will allow providers to avoid undiagnosed postpartum urinary retention and its repercussions. Improved screening and education regarding urinary incontinence in the peripartum is important for early management, such as pelvic floor muscle training, and improved quality of life.
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Affiliation(s)
- Shirley M Dong
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Li S, Zhang X, Liu Y, Wang Y, Zheng X. The Occurrence and Factors Associated with Overt Urinary Retention Among Postpartum Women After Vaginal Delivery with Labor Epidural Analgesia. Int J Gen Med 2023; 16:5333-5341. [PMID: 38021064 PMCID: PMC10658807 DOI: 10.2147/ijgm.s440161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background 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. Methods 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. Results 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, P=0.022), lateral episiotomy (OR=4.55, 95% CI: 1.91-10.80, P=0.001), and perineal pain (OR=4.23, 95% CI: 2.05-8.73, P<0.001) were factors affecting overt PUR for these women. Conclusion 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.
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Affiliation(s)
- Sen Li
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Xiaohong Zhang
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Yan Liu
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Yongli Wang
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Xujuan Zheng
- Medical School, Shenzhen University, Shenzhen, 518060, People’s Republic of China
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Chen HT, Luo TZ, Jiang ZY, Dai SD, Xia HA, Yang S, Huang SY, Chen LP. Noninvasive external therapy of traditional Chinese medicine for preventing postpartum urinary retention in women with vaginal delivery: A network meta-analysis. Medicine (Baltimore) 2023; 102:e35399. [PMID: 37832117 PMCID: PMC10578683 DOI: 10.1097/md.0000000000035399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND To compare the effect of different noninvasive external therapies of traditional Chinese medicine (TCM) on the prevention of postpartum urinary retention (PUR) using a network meta-analysis (NMA). METHODS A search of the China National Knowledge Infrastructure, WanFangDate, VIP, China Biomedical Literature Database, PubMed, The Cochrane Library, Embase, and Web of Science databases were reviewed for related randomized controlled trials dated between database inception and December 31, 2022, on the prevention of PUR by noninvasive TCM. Two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies; then, a NMA was performed using Revman5.3 software, State13.1 software, and frequency methodology. RESULTS In total, 16 studies involving 3637 cases of parturients and 9 types of noninvasive TCM external treatments were incorporated into the NMA. The NMA results show that based on routine nursing, in terms of reducing the incidence of urinary retention, acupoint compressing combined with auricular acupressure is ranked first, followed by acupoint hot compress, acupoint massage combined with auricular acupressure, Yin-Yang therapy, acupoint massage, auricular acupressure, acupoint compressing, and routine nursing. In terms of urination time, acupoint compressing combined with auricular acupressure ranked first, followed by acupoint massage combined with auricular acupressure, acupoint electrical stimulation, acupoint compressing, TCM heating therapy, acupoint massage, auricular acupressure, and routine nursing. In terms of reducing residual urine volume after the first urination, acupoint compressing combined with auricular acupressure was ranked first, followed by auricular acupressure, acupoint compressing, acupoint massage, TCM heating therapy, and routine nursing. CONCLUSION Current evidence shows that acupoint compressing combined with auricular acupressure may be the best noninvasive TCM treatment for preventing PUR based on routine nursing; however, further high-quality clinical randomized controlled trials are needed for validation and support.
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Affiliation(s)
- Hua-Ting Chen
- The Third Clinical College of Guangzhou Medical University, The Nursing College of Guangzhou Medical University, Guangzhou, China
| | - Tai-Zhen Luo
- Department of Nursing, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zi-Yan Jiang
- Department of Obstetrics and Gynecology, Obstetrics, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si-Di Dai
- The Third Clinical College of Guangzhou Medical University, The Nursing College of Guangzhou Medical University, Guangzhou, China
| | - Hua-An Xia
- Department of Nursing, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuai Yang
- Department of Obstetrics and Gynecology, Obstetrics, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shi-Ying Huang
- Department of Cardiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Li-Ping Chen
- Department of Nursing, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Zheng VJ, Geynisman-Tan J, Knoll J, Kenton K, Brown O. Accuracy of Bladder Scanner in Measuring Bladder Volumes in Postpartum Women. UROGYNECOLOGY (PHILADELPHIA, PA.) 2023; 29:777-783. [PMID: 37607312 DOI: 10.1097/spv.0000000000001337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
IMPORTANCE Ultrasound bladder scanners may provide a less invasive method to measure postpartum urinary volume, but their accuracy must be validated. OBJECTIVE The objective of this study was to evaluate the accuracy of a bladder scanner in measuring bladder volumes in postpartum women. The secondary objective was to evaluate the effect of obesity on scanner accuracy. STUDY DESIGN This prospective cohort study included women older than 18 years who gave birth vaginally at term gestation. After delivery, we obtained 3 sequential measurements of the bladder volume using an ultrasound bladder scanner. We then measured true bladder volume by transurethral catheterization. The primary outcome was the absolute difference between the bladder scanner volume and the catheterized volume. A Wilcoxon signed-rank test was used to compare absolute median difference between the bladder scan volume and true catheter volume. Repeated-measures analysis of variance and linear regression were used to evaluate the effect of obesity on the accuracy of the bladder scanner. RESULTS We enrolled 70 patients (61.4% nulliparous, 38.6% multiparous). One delivery was vacuum-assisted, 4 were forceps-assisted, and 65 were spontaneous vaginal. The median age was 34 years, and median body mass index was 30.5. Median difference between bladder scanner and catheter volume was 42.7 mL (P < 0.001), with the scanner underestimating true volume 82.9% of the time. The scanner was less accurate in patients with a body mass index ≥ 30 (P = 0.001). CONCLUSIONS The bladder scanner is less accurate than catheterized urine volume. However, the median difference between the bladder scanner and the catheterized volume is 42.7 mL, making it suitable for clinical use. Accuracy deteriorates in obese patients.
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Affiliation(s)
| | | | - Justin Knoll
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
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11
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Bernstein SL. Postpartum Urinary Retention. MCN Am J Matern Child Nurs 2023; 48:224. [PMID: 37365705 DOI: 10.1097/nmc.0000000000000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Affiliation(s)
- Samantha L Bernstein
- Samantha L. Bernstein is an Assistant Professor, MGH Institute of Health Professions, Boston, MA. Dr. Bernstein can be reached via email at
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