Acute post-partum urinary retention: analysis of risk factors, a case-control study.
OBJECTIVE
The aim of this retrospective case-control study was to assess clinical factors that can predict the occurrence of post-partum urinary retention (PPUR) and evaluate their influence as independent risk factors.


METHODS
Between January 2008 and December 2010, 11,108 vaginal deliveries were performed. 105 women who suffered from PPUR were detected by retrospective data analysis. PPUR was defined as the inability to have spontaneous micturition within 6 h after vaginal delivery.


RESULTS
Data analysis detected six risk factors for PPUR on-set: primiparity, vacuum-assisted delivery, uterine fundal pressure during the second stage of labor (Kristeller's maneuver), a longer second stage of labor, medio-lateral episiotomy, initial higher dose of epidural analgesia. Nevertheless, logistic regression showed that only vacuum-assisted delivery and Kristeller's maneuver were significant independent risk factors (P = 0.001 and 0.009, respectively).


CONCLUSIONS
Our study identified these risk factors as the cause of mechanical and neurological damage, which can lead to post-partum urinary retention. By early diagnosis, a prompt and appropriate management of PPUR can be established in order to assure a rapid return to normal bladder function after vaginal delivery.
Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico di Milano, viale Filippetti 33, 20122, Milan, Italy.
Paola
P
Pifarotti
Clara
C
Gargasole
Chiara
C
Folcini
Umberto
U
Gattei
Emanuela
E
Nieddu
Giuseppe
G
Sofi
Arturo
A
Buonaguidi
Michele
M
Meschia
D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D016015:Logistic Models; D011247:Pregnancy; D011312:Pressure / Q000009:adverse effects; D011644:Puerperal Disorders / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016055:Urinary Retention / Q000209:etiology*; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects