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Postpartum urinary retention
J W Saultz1, W L Toffler, J Y Shackles
1Department of Family Medicine, Oregon Health Sciences University, Portland 97201.
Background:
Urinary retention is a common and frustrating complication in women during the immediate postpartum period. Physiologic changes in the bladder that occur during pregnancy predispose patients to develop symptomatic retention of urine during the first hours to days after delivery.
Methods:
The incidence and characteristics of postpartum urinary retention were researched through a literature review and are illustrated by a case report.
Results And Conclusions:
Postpartum urinary retention has a reported incidence ranging from 1.7 to 17.9 percent. Factors associated with postpartum urinary retention include (1) first vaginal delivery, (2) epidural anesthesia, and (3) Cesarean section. Treatment begins with supportive measures to enhance the likelihood of micturition, such as ambulation, privacy, and a warm bath. If these measures are not successful, catheterization can be performed. If the bladder contains more than 700 mL of urine, prophylactic antibiotics may be warranted, because prolonged or repeated catheterization may be necessary.