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Use of epidural anesthesia and the risk of acute postpartum urinary retention
Kimberly L Musselwhite1, Peter Faris, Katherine Moore
1Calgary Health Region, Calgary, AB, Canada.
Objective:
We aimed to examine the relationship between the use of epidural analgesia during labor and acute postpartum urinary retention.
Study Design:
A retrospective cohort study was conducted using 1994 labor and postpartum health records from 3 primary care centers.
Results:
Logistic regression analysis revealed that a longer second stage of labor (odds ratio [OR] 2.62; 95% confidence interval [CI] 1.41-4.85), use of systemic narcotics (OR 1.63; 95% CI 1.04-2.57), perineal laceration (OR 1.73; 95% CI 1.02-2.91), and instrumental delivery (OR 1.86; 95% CI 1.16-2.97) predicted urinary retention. There was a trend toward association of epidural analgesia and urinary retention (OR 1.69; 95% CI 0.98-2.92). Propensity score analysis revealed that any effect of epidural analgesia was likely due to effect modification of other obstetric variables.
Conclusion:
Epidural analgesia during labor may increase the risk of developing urinary retention by up to 3 times. However, this effect is mediated by other obstetric variables.
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