Multisite Randomized Controlled Trial of Bladder Management in Labor With Epidural Analgesia/Anesthesia

Area of Science:

• Obstetrics and Gynecology
• Urology
• Anesthesiology

Background:

• Urinary catheterization is common during labor with epidural analgesia.
• The optimal method of urinary catheterization (continuous indwelling vs. intermittent) during labor remains debated.
• Potential complications include urinary tract infection (UTI) and effects on mode of birth.

Purpose of the Study:

• To compare continuous indwelling catheterization with intermittent catheterization during labor with epidural analgesia/anesthesia.
• To evaluate the impact on mode of birth.
• To assess the incidence of postpartum urinary tract infection (UTI) symptoms.

Main Methods:

• A randomized clinical trial was conducted with 252 nulliparous women in labor receiving epidural analgesia/anesthesia.
• Participants were randomized to either continuous indwelling or intermittent (every 2 hours) catheterization.
• Postpartum UTI symptoms were assessed via questionnaire 1-2 weeks after discharge.

Main Results:

• No significant difference was observed in the incidence of cesarean birth between the indwelling (15.6%) and intermittent (22.5%) catheterization groups (p=0.172).
• Overall, 3% of participants reported UTI symptoms within 2 weeks postpartum, with no significant difference between the groups (p=0.929).
• Demographic characteristics were similar between the two catheterization groups.

Conclusions:

• Neither continuous indwelling nor intermittent catheterization during labor with epidural analgesia/anesthesia demonstrated a difference in mode of birth or postpartum UTI symptoms.
• Further research is warranted using objective UTI diagnostic data and larger sample sizes.
• Investigating confounding variables related to cesarean birth after labor catheterization is recommended.