Urinary catheterisation in labour
This article aims to provide a brief overview of the use, indications and possible complications of urinary catheterisation in the intrapartum period. The inter-connected relationship between regional anaesthesia, mobility, infection and bladder function in labour and the immediate postpartum period are explored.
Care of the bladder in labour is essential to supporting the physiological process of labour. A full bladder can often be palpated above the brim of the pelvis, may hinder descent of the presenting part of the baby and potentially prolong the length of the labour as a result. Recommendations include frequency of passing urine for women on admission, throughout labour and in the third stage (National Institute for Health and Care Excellence (NICE), 2014a). Adequate bladder care can reduce the incidence of bladder over-distension and enable prompt recognition and appropriate management of women who have voiding dysfunction.
The importance of mobilisation during labour was explored by Weiniger et al (2009). The post-void residual volume during this trial was measured by trans-abdominal ultrasound and was found to be higher among the labouring women who received epidural analgesia than those who received no or alternative analgesia. Fewer of the women who managed to walk to the toilet required urinary bladder catheterisation during the labour than women who used the bedpan. However, low-risk women who were randomised to walk to the bathroom with epidural analgesia and were able to do so during labour had a significantly reduced post-void residual volume, and a reduced requirement for urinary catheterisation (Weiniger et al, 2009).
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