Acute post-partum urinary retention: analysis of risk factors, a case-control study

The aim of this retrospective case-control study was to assess clinical factors that can predict the occurrence of post-partum urinary retention (PPUR) and evaluate their influence as independent risk factors. Between January 2008 and December 2010, 11,108 vaginal deliveries were performed. 105 women who suffered from PPUR were detected by retrospective data analysis. PPUR was defined as the inability to have spontaneous micturition within 6 h after vaginal delivery. Data analysis detected six risk factors for PPUR on-set: primiparity, vacuum-assisted delivery, uterine fundal pressure during the second stage of labor (Kristeller's maneuver), a longer second stage of labor, medio-lateral episiotomy, initial higher dose of epidural analgesia. Nevertheless, logistic regression showed that only vacuum-assisted delivery and Kristeller's maneuver were significant independent risk factors (P = 0.001 and 0.009, respectively). Our study identified these risk factors as the cause of mechanical and neurological damage, which can lead to post-partum urinary retention. By early diagnosis, a prompt and appropriate management of PPUR can be established in order to assure a rapid return to normal bladder function after vaginal delivery.