Re: Catheter Question/Post Childbirth
From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Sun, 31 Oct 1999 11:01:33 -0600 (CST)
Mary,
Excellent and well researched answer. Thank you and come back again.
Harvey Marchbein, M.D. FACOG, FACS
At Fri, 29 Oct 1999, mary wrote:
>
>Hello, my name is Mary; I am a nursing student at the University of North
>Dakota. I came across your question on the Woman's Health Forum list serve
>and I hope that I can answer your questions. I found some information in
>my textbook and some journals that might be of interest to you. You
>mentioned an epidural was administered about an hour prior to delivery. In
>my reading, I found that women who have had an epidural will have problems
>emptying their bladder, and are more susceptible to urinary retention
>(Olds, London, Ladwig, 1996).
> After you have your baby, your risk for a urinary tract infection is
>increased; there are several reasons that this occurs. After a normal
>pregnancy urinary output will increase, but if there is swelling around the
>bladder the flow of urine is slowed, thus making it hard to urinate. The
>chance of a Urinary tract infection will increase, because of the presence
>of bacteria (Olds, London, Ladwig, 1996).
> I also went to the medical library and researched some journals for
>you. I found two that you might be interested in looking up. There was a
>study done to find out the relationship between increased bladder capacity
>and deceased bladder sensitivity from stretching or trauma. One of the
>findings that came out of this article was the association between
>postpartum urinary retention and the length of the first and second stage
>of labor. The ability to urinate may be difficult because of swelling due
>to the fetus putting pressure in the pelvic area (Gentry & Liu, 1997).
>Another article talked about other medications (i.e. epidural infusion of
>morphine) also to be linked to difficulty in urinating (Yip, Grieger, Hin &
>Ching, 1997).
> As far your pain when urinating it could be due to either, a urinary
>tract infection, swelling, bruising around the urethra or episiotomy site.
>I hope that the information provided to you will be beneficial. I would
>also encourage you to seek the advice of your medical doctor if you have
>any further concerns in regards to your questions.
> Thank you,
> Mary McGreevy
> College of Nursing
> University of North Dakota
>
> Olds, S., London, M., & Ladewig, P. (1996). Maternal newborn nursing
>a family centered approach (5th ed.). California: Addison-Wesley.
>
> J.A. Gedney. & e.h.c., Liu (1998). Side effects of epidural infusions
>of upload bupivacaine mixtures. Anesthesia, 53, (12): p. 1148-1155.
>
> Shing-Kai Yip, Geoffrey Brieger, Lin-Yee Hin & Tony Chung (1977).
>Urinary Retention in the post-partum period. ACTA Obstetricia ET
>Gynecologica Scandinavica: 76 (7): 667-72.
--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York
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