Postpartum Urinary Retention Dangerous?
Urinary retention in the postpartum mother is one of the common complications, especially during vaginal delivery. Need to understand the status of the disease to take preventive measures as well as active treatment to help the mother relieve unpleasant things.
Postpartum urinary retention in women
Urinary retention is a disorder of the urinary tract, which indicates symptoms of urination but cannot urinate, and a bladder bridge is detected during a physical examination. Women with postpartum urinary retention tend to feel tense when the abdomen is pressed. After instructing women to practice urinating, such as sitting in a natural position, or applying warm compresses to the abdomen below the navel, the woman is still unable to urinate on her own, and the feeling of tension and discomfort is increasing
Causes should urinary retention after birth
With women giving birth often
During labor, when the fetus is low, the fetus often presses on the neck of the bladder or urethra to cause stagnation of urine. From there, the bladder relaxes, when stretching causes loss of tone and constriction of the bladder neck muscles.
Some cases during birth have to have an episiotomy to make it easier for the fetus to open the fetus
In addition, when urinary retention, urinary movement repeatedly causes cystitis, making symptoms of urine clear.
With women having a cesarean section
Spinal anesthetic with Bupivacaine and Fentanyl content (belonging to opioid group) has a rate of urinary retention of 10-15% after surgery. Therefore, have to wait patiently until the end of the effect of the drug for the mother to urinate to be diagnosed clearly. In addition, for women undergoing cesarean section, injuries due to rough procedures, bladder extubation cause bladder paralysis and urinary retention.
Clinical manifestations of urinary retention
Clinical manifestations are about 3-4 hours after giving birth, mothers feel sad but unable to urinate. Physical examination shows that the soft abdomen, the navel area is the uterus with good elasticity, while another sphere is the bladder bridge. When the abdomen presses feel tight
The clinical manifestation of postpartum urinary retention is that the mother feels sad but cannot urinate
Treatment of urinary retention for postpartum women
Principles of treatment of urinary retention
Practice urinating to recreate the urination reflex.
Use antibiotics to fight infections.
Using anti-inflammatory anti-edema compresses bladder neck.
Helps increase bladder tonicity to help the ability to shrink the bladder back to normal.
Management process when urinary retention
Practice urinating in a natural sitting position, avoiding pain due to pain
Sonde was put in urine and kept for 24 hours if the woman went to the bathroom and she still could not urinate. Put the urine sonde in place and remove the clamp every 3-4 hours, creating a urination reflex. When removing the clamp, the mother must practice urinating through sonde. Before 4-hour catheterization, urination catheter clamps 4 hours, waiting for a sense of urination, for the mother to push urine through the sonde, if the urine is passed through the sonde, the new catheter is drawn.
Points to note when catheterization:
Tools (especially urinary sonde) must be absolutely sterile to avoid upstream infections.
The technique performed must be in the right way and absolutely sterile.
Do not use urine sonde that is too large to cause injury, or edema.
The movement must be gentle, avoid rough and cause scratches of the urinary tract, if entangled to do again or tell the patient to open his mouth to breathe evenly to reduce urinary spasm.
If bacteriological test urine is taken, bacteria should be collected in the middle of the stream, so it should be taken directly into a sterile test tube.
Do not leave the catheter for more than 48 hours (except in the case of a doctor's prescription).
Do not urinate many times a day.
If the patient's bladder is too tight, urine should be drained slowly and not fully drained from the bladder, as this will reduce sudden pressure in the bladder and cause bleeding.
One way to prevent bleeding is to place a small small tube, or to place a normal small tube and clamp, then remove and clamp to relieve the pressure slowly.
Monitor the bladder during and after catheterization to detect abnormal signs and manage them promptly.
Use of medication
Taking antibiotics against infections is often indicated as cephalexin, doncef, augmentin. These drugs are taken orally and continuously for 7 days on average.
Use anti-inflammatory medications to prevent edema from compressing the bladder neck. Anti-edema drugs such as alphachymotrypsin, buscopan ...
Taking a tonic booster and bladder contraction with prostigmin or xatral for 4-5 days will help the bladder contract to return to normal.
Also combine vitamins B1, vitamin B6 and vitamin B12 to increase health.
How to prevent urinary retention
Mom should note early mobilization.
Drink a lot of water.
Do not urinate due to postpartum pain. Encourage mothers to urinate on their own to avoid fear of pain for episiotomy.
Practice urinating in a natural sitting position.
Wash or soak the genital area with warm water (flushing the vulva with warm water), or extra toilet rinse.
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