Effectiveness of Bian stone warming and ironing combined with aromatherapy on postpartum urinary retention among lying-in women with painless delivery / 预防医学

Objective@#To evaluate the effectiveness of Bian stone warming and ironing combined with aromatherapy on postpartum urinary retention among lying-in women with painless delivery, so as to provide the reference for preventing postpartum urinary retention after painless delivery.@*Methods@#Lying-in women who underwent painless delivery in the Hangzhou Women' s Hospital were randomly assigned into the intervention and control group. Participants in the intervention group were given Bian stone warming and ironing combined with essential oil aromatherapy, while participants in the control group were given routine nursing care. The first postpartum urination and urinary retention were recorded, nursing satisfaction was investigated using Newcastle Satisfaction with Nursing Scale, the quality of life was evaluated using The World Health Organization Quality of Life-BREF, and these indicators were compared between the two groups.@*Results@#There were 92 participants in the intervention group, with a mean age of (26.51±1.31) years and mean gestational age of (38.11±0.55) weeks, and 86 participants in the control group, with a mean age of (26.61±1.24) years and mean gestational age of (38.28±0.72) weeks. There was no statistically significant difference in the general data between the two groups (P>0.05). The time of first urination in the intervention group was shorter than that in the control group [(2.91±1.02) h vs. (3.76±1.68) h], the first postpartum urine volume was more than that in the control group [(160.56±21.03) mL vs. (142.43±18.42) mL], the residual urine volume of the bladder after the first urination was less than that in the control group [(73.20±17.03) mL vs. (85.46±20.24) mL], the incidence of urinary retention was lower than that in the control group (3.26% vs. 10.47%), nursing satisfaction was higher than that in the control group, and the increase in scores of all dimensions of quality of life was greater than that in the control group, with statistically significant differences (all P<0.05). @*Conclusions@#Bian stone warming and ironing therapy combined with aromatherapy may effectively reduce the incidence of postpartum urinary retention, and improve nursing satisfaction and quality of life among lying-in women after painless delivery.

Current status and influencing factors of protracted postpartum urinary retention in women with labor analgesia / 中国实用护理杂志

Objective:To explore the current status and the influencing factors of protracted postpartum urinary retention(P-PUR) in women with labor analgesia, so as to provide evidences for early diagnosis and timely intervention for P-PUR.Methods:A total of 41 995 women who were given vaginal delivery under labor analgesia from January 2017 to October 2020 in Women′s Hospital of Nanjing Medical University were chosen as the research objects. A retrospective analysis was performed for the clinical data of 62 women with P-PUR, and a 1∶4 matching case control study was conducted. Logistic regression analysis was used to analyze the variables with statistical difference in univariate analysis, so as to explore the independent influencing factors of P-PUR in women with labor analgesia.Results:Among 41 995 women with labor analgesia, 62 women suffered from P-PUR, and the incidence was about 0.15% (62/41 995). The Logistic regression model showed that nulliparity ( OR=121.80, 95% CI 8.59-1 727.40, P<0.05), forceps delivery ( OR=13.41, 95% CI 2.21-81.58, P<0.05),Ⅱdegree porineal iaceration ( OR=0.04, 95% CI 0.01-0.11, P<0.05), episiotomy ( OR=0.13, 95% CI 0.04-0.47, P<0.05) and perineotomy with perineal laceration ( OR=0.20, 95% CI 0.06-0.63, P<0.05) were the independent risk factors. Conclusions:For primiparas with labor analgesia, interventions should be taken to reduce perineal injury, and indications of forceps delivery should be strictly controlled, so as to reduce P-PUR and adverse urinary tract complications.

Estimulación del nervio tibial posterior en el tratamiento de la retención urinaria posparto. Reporte de dos casos / Posterior tibial nerve stimulation in the management of postpartum urinary retention. Report of two cases

Resumen OBJETIVO: Reportar dos casos de pacientes con el efecto de la estimulación del nervio tibial posterior en la retención urinaria posparto. CASOS CLÍNICOS: Caso 1: Paciente de 41 años, con dos cesáreas previas, sobrepeso (IMC 28 kg/m2), con 33 semanas de embarazo, hipertensión arterial crónica y preeclampsia sobreagregada asociada con datos de déficit neurológico. En el puerperio tardío tuvo dificultad para miccionar y dolor suprapúbico. Con base en la urodinamia se diagnosticó: disinergia detrusor-esfínter y se trató con estimulación del nervio tibial posterior durante 20 minutos cada semana con duración de fase de 200 µs y frecuencias de 10 Hz durante 12 sesiones. Los parámetros urodinámicos mejoraron y se restablecieron las micciones espontáneas, se redujo la frecuencia del cateterismo limpio intermitente y el efecto continuó a 31 meses de seguimiento. Caso 2: Paciente de 38 años, primigesta, IMC 21 kg/m2 , con antecedente de hipotiroidismo subclínico. A los cinco días de puerperio tuvo retención urinaria de 2000 mL; se le colocó una sonda Foley a drenaje contínuo y, posteriormente, un tapón con vaciado cada 2 horas. No obstante lo anterior tuvo nuevos episodios de retención urinaria que ameritaron el inicio del cateterismo limpio intermitente, 5 en 24 horas y estimulación del nervio tibial posterior con corriente bifásica asimétrica. Se consiguió una mejoría subjetiva del 100% y cambios urodinámicos. Las micciones espontáneas se reiniciaron sin requerir cateterismo limpio intermitente, fue dada de alta luego de un año de seguimiento. CONCLUSIÓN: De acuerdo con los desenlaces del estudio, la estimulación del nervio tibial posterior podría ofrecer una alternativa de tratamiento prometedora en pacientes con retención urinaria posparto.

Abstract OBJECTIVE: Case report of the effect of posterior tibial nerve stimulation on postpartum urinary retention. CASE REPORT: Case 1: 41-year-old patient, with two previous cesarean sections, overweight (BMI 28 kg/m2), 33 weeks of pregnancy, chronic arterial hypertension and over-aggregated preeclampsia associated with data of neurological deficit. In the late puerperium she had difficulty urinating and suprapubic pain. Based on urodynamics, detrusor-sphincter dyssynergia was diagnosed and she was treated with posterior tibial nerve stimulation for 20 minutes every week with phase duration 200 µs and frequency 10 Hz during 12 sessions. Urodynamic parameters improved and spontaneous micturition was restored, the frequency of intermittent clean catheterization was reduced, and the effect continued at 31 months follow-up. Case 2: 38-year-old primigravida patient, BMI 21 kg/m2, with a history of subclinical hypothyroidism. Five days postpartum she had urinary retention of 2000 mL; a Foley catheter was placed for continuous drainage and, subsequently, a plug with emptying every 2 hours. Notwithstanding the above, she had new episodes of urinary retention that warranted the initiation of intermittent clean catheterization, 5 in 24 hours and stimulation of the posterior tibial nerve with asymmetric biphasic current, she had a subjective improvement of 100% and urodynamic changes. Spontaneous urination resumed without requiring intermittent clean catheterization, she was discharged after one year of follow-up. CONCLUSION: According to the study outcomes, posterior tibial nerve stimulation could offer a promising treatment alternative in patients with postpartum urinary retention.

Acupuncture at Ciliao (BL 32) for prevention of postpartum urinary retention in elderly parturient women: a randomized controlled trial / 中国针灸

OBJECTIVE@#To explore the preventive effect of acupuncture at Ciliao (BL 32) on postpartum urinary retention as well as the time and volume of the first urination after delivery in elderly parturient women undergoing vaginal delivery.@*METHODS@#A total of 180 elderly parturient women (≥35 years old) undergoing vaginal delivery were randomly divided into a blank control group, a conditional control group and an observation group, 60 cases in each group. The patients in the blank control group were treated with routine nursing plan; based on the treatment of the blank control group, the patients in the conditional control group were treated with additional intervention measures such as applying hot towel on the bladder and fingers pressing to stimulate urination; based on the treatment of the blank control group, the patients in the observation group were treated with acupuncture at bilateral Ciliao (BL 32) one hour after delivery for 20 min (the acupuncture was given only once). The incidence rate of postpartum urinary retention as well as the time and volume of the first urination among the women without urinary retention were observed; the satisfaction rate of the 3 groups was recorded.@*RESULTS@#The incidence rate of postpartum urinary retention in the observation group was 5.0% (3/60), which was significantly lower than 26.7% (16/60) in the blank control group (<0.01) and 16.7% (10/60) in the conditional control group (<0.05); the incidence rate of postpartum urinary retention in the conditional control group was significantly lower than that in the blank control group [16.7% (10/60) vs 26.7%(16/60), <0.05]. In the elderly women without urinary retention, the first urination time in the observation group was significantly earlier than that in the blank control group and conditional control group (<0.01), and the first urination time in the conditional control group was earlier than that in the blank control group (<0.01). The volume of first urination in the observation group was higher than that in the blank control group and the conditional control group (<0.05, <0.01). The satisfaction rates in the observation group and conditional control group were higher than that in the blank control group (<0.01).@*CONCLUSION@#Acupuncture at Ciliao (BL 32) could effectively prevent the postpartum urinary retention, improve the time and volume of the first urination in elderly parturient women undergoing vaginal delivery.

Clinical observation of rapid massage at Shuidao (ST 28) to prevent postpartum urinary retention / 中国针灸

OBJECTIVE@#To explore the clinical effect of rapid massage at Shuidao (ST 28) to prevent puerpera from postpartum urinary retention.@*METHODS@#A total of 200 puerpera giving birth through vagina were enrolled and divided into an observation group and a control group according to the random number table method, 100 cases in each group. In the observation group, rapid massage at Shuidao (ST 28) was applied. In the control group,there was no intervention and urinated naturally. The traditional Chinese medicine syndrome scale was used to evaluate poor sense of urination, and record puerpera with or without postpartum urinary retention, the poor sense of first urination, the first time of urination, the amount of first urination and postpartum hemorrhage.@*RESULTS@#The poor sense of first urination in the observation group was significantly lower than that in the control (<0.001), the first time of urination in the observation group was significantly earlier than that in the control group (<0.001), the amount of first urination in the observation group was significantly more than that in the control group (<0.001), the observation group was superior to the control group to prevent postpartum urinary retention (<0.05).@*CONCLUSION@#Rapid massage at Shuidao (ST 28) can reduce the poor sense of first urination, significantly advance the time of spontaneous urination, significantly increase the amount of first urination and effectively prevent postpartum urinary retention.

Retención urinaria posparto: conducta clínica y modelos experimentales para su estudio / Postpartum urinary retention: clinical behavior and experimental models for study

Resumen ANTECEDENTES: puesto que la retención urinaria posparto no es un suceso que se considere grave, la información de su tratamiento en las unidades obstétricas es muy limitada, sobre todo en América Latina. MÉTODO: búsqueda de información publicada, en español e inglés, entre los años 2000 y 2016 relacionada con las medidas preventivas y tratamientos de la retención urinaria posparto en dos bases de datos de bibliografía biomédica: Pubmed y Scopus. RESULTADOS: se encontraron 31 artículos científicos en inglés relacionados con el tratamiento de la retención urinaria posparto y pocos estudios en modelos animales de retención urinaria aguda, ninguno en español. El diagnóstico de la retención urinaria posparto se establece con el auxilio de métodos invasivos y no invasivos: catéteres y ultrasonido. El tratamiento incluye acciones preventivas (reducción de problemas del parto mediante adiestramiento adecuado del personal de las unidades obstétricas o la aplicación de masaje en la región sacra) y posteriores al parto (uso de catéteres uretrales o suprapúbicos). CONCLUSIONES: la retención urinaria posparto es una complicación clínica que requiere entender que el diagnóstico y tratamiento tempranos contribuyen sustancialmente a disminuir la alta prevalencia de disfunciones vesicales femeninas. En esta revisión se evidenció la necesidad de estudios preclínicos que permitan conocer la repercusión a largo plazo de la retención urinaria y probar nuevos tratamientos.

Abstract BACKGROUND: since postpartum urinary retention is not a condition that is considered severe, information of its treatment in obstetrical units is very limited, especially in Latin America. METHOD: search of published information in Spanish and English, between 2000 and 2016 related to preventive measures and treatment of postpartum urinary retention in two data bases of biomedical bibliography: Pubmed and Scopus. RESULTS: 31 scientific articles in English related to the treatment of postpartum urinary retention were found as well as a few studies of acute urinary retention in animal models, none of them in Spanish. The diagnosis of postpartum urinary retention is established using invasive and non-invasive methods: catheters and ultrasound. Treatment includes preventive measures (reduction of delivery issues through appropriate training of obstetrical unis or the use of massage on the sacral region) and after delivery (use of urethral or suprapubic catheters). CONCLUSIONS: postpartum urinary retention is a clinical complication, thus we have to understand that early diagnosis and treatment substantially contribute to decreasing the high prevalence of female bladder dysfunctions. In this review, we proved the need for preclinical tests that allow us to recognize the long term repercussion of urinary retention and test new treatments.

Influential factors and incidence of postpartum urinary retention after forceps delivery / 现代临床护理

Objective To investigate influential factors and incidence of postpartum urinary retention after forceps delivery. Method The clinical data of 216 cases of puerperas undergoing forceps delivery in our hospital from January 2012 and July 2015 were collected and investigated in terms of postpartum urinary retention as well as its influencing factors. Results The incidence rate of postpartum urinary retention was 24.07%(52/216).Logistic multivariate regression analysis showed the significant positive variables for the outcomes included:the first stage of labor and postpartum 2h bleeding.Conclusion The first stage of labor time and postpartum 2h bleeding are the high risk factors of uroschesis after forceps delivery.

Preventive effect of clinical nursing pathway of health education on postpartum urinary retention / 现代临床护理

Objective To investigate the preventive effect of clinical nursing pathway of health education on partum urinary retention.Methods Two hundred and forty primiparas hospitalized in our hospital from September 2012 to February 2013 were randomized equally into the observation group and the control group.The former received health education by clinical nursing pathway and the control group conventional health education.The two groups were compared in terms of incidence of postpartum urinary retention.Results The incidences of postpartum urinary retention in the observation group and the control one were 3.33% and 11.67%,respectively.The difference in the incidence between the groups were statistically significant(P<0.05).Conclusion The clinical nursing pathway of health education may effectively prevent the occurrence of postpartum urinary retention.

Application of clinical pathway in the health education for prevention of postpartum urinary retention and effect evaluation / 中国实用护理杂志

Objective To investigate the clinical pathway in the health education for prevention of postpartum urinary retention and effect evaluation. Methods 150 cases who completed delivery in our hospital were set as the observation group, they received health education of clinical pathways. 150 pregnant women who completed delivery in our hospital in the past were named as the control group, they were given traditional health education. The incidence rate of urinary retention was compared between the two groups. Results 7 cases, accounting for 4.67% of urinary retention occurred in the observation group, 24 patients, accounted for 16.00% of urinary retention occurred in the control group, the incidence of urinary retention in the experimental group was significantly lower than the control group. Conclusions Application of clinical pathway in the health education for prevention of postpartum urinary retention has good clinical value, can largely reduce the incidence of urinary retention.