Introduction Unrecognised peripartum urinary retention may cause chronic voiding dysfunction and may be prevented by good bladder care. This audit studies the quality of peripartum bladder care in a London teaching hospital.
Methods Bladder care during 50 consecutive deliveries in August 2010 was audited retrospectively against local guideline standards.
Results Standards focus on timing and volume of first postpartum void and referral procedures in case of postpartum voiding problems. 28/50 (56%) of patients were catheterised due to epidural use or operative delivery.
Only one of three patients with postpartum voiding problems was further investigated and referred to an appropriate clinician.
Discussion Our results suggest that there is potential for unrecognised urinary retention postnatally. Although our sample is small, these numbers are disappointing, especially in the presence of a clear guideline. The quality of bladder care is worse after removal of catheter despite the higher risk of bladder complications in this group due to use of regional anaesthesia and operative delivery.
A possible explanation is the lower staffing level in the postnatal ward, where catheters are removed, compared with labour ward, where first voids after vaginal delivery are likely to happen. Routine use of jugs for first postpartum voids and better patient information might prevent “undocumented” voids. Better staffing levels might help and staff education about importance of bladder care must be encouraged.
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