How the Method of Bladder Emptying After Epidural Placement in Labor Affects Postpartum Voiding
Purpose
At least ten percent of patients have postpartum urinary retention or difficulty urinating after birth, which can cause incontinence and other urinary problems long-term. After getting an epidural placed, patients should be numb in their pelvic region. This numbness makes it difficult to feel the need to urinate, so patients need a urinary catheter placed to empty the bladder. Some patients have one catheter placed throughout their labor and others have a catheter placed to empty the bladder then removed every few hours. The investigators are studying whether placing a catheter once or catheterizing multiple times affects the rate of postpartum urinary problems and infection.
Conditions
- Urinary Retention
- Urinary Tract Infection (Diagnosis)
- Postpartum Acute Urinary Retention
- Postpartum Care
- Voiding Dysfunction
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Pregnant patients planning vaginal delivery presenting in labor or for induction of labor - Age 18 years and older - Live fetus - Receive epidural anesthesia
Exclusion Criteria
- those under 18 years old - those with stillbirth - those with baseline overactive bladder symptoms, neurogenic bladder diagnoses, or otherwise using bladder catheterization during pregnancy Patients will be excluded from UTI analyses if: - they received antibiotics intrapartum - had bacteriuria diagnosed by a clean catch specimen showing >100,000 CFU/mL of a single bacterial species, regardless of symptoms
Study Design
- Phase
- N/A
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Intervention Model Description
- Allocation will be determined based on a previously generated randomization scheme created by the NCI Clinical Trials Randomization Tool.
- Primary Purpose
- Prevention
- Masking
- Double (Investigator, Outcomes Assessor)
- Masking Description
- While the patient, nursing team, and delivery providers will not be blinded to the catheterization method, the provider making the diagnosis of postpartum urinary retention will be blinded to the exposure group.
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Active Comparator Intermittent catheterization |
|
|
|
Active Comparator Continuous catheterization |
|
Recruiting Locations
Pittsburgh 5206379, Pennsylvania 6254927 15217
More Details
- Status
- Recruiting
- Sponsor
- University of Pittsburgh
Detailed Description
This is a randomized controlled trial to assess the effect of bladder catheterization method during labor with epidural anesthesia on the rate of postpartum urinary retention.