Postpartum Urinary Retention after Vaginal Delivery

Abstract

Postpartum Urinary Retention after Vaginal Delivery Retensi Urin pada Pasien Pascasalin Pervaginam Bonifacius Bayu, Rudy Lengkong, John Wantania Department of Obstetrics and Gynecology Faculty of Medicine Universitas Sam Ratulangi Prof. Dr. R.D.Kandou General Hospital Manado Abstract Abstrak Objective : To determine the incidence of postpartum Tujuan : Mengetahui angka kejadian retensi urin di kota urinary retention (PUR) after vaginal delivery and to specify Manado dan mengetahui faktor risiko obstetri yang berperan any obstetric risk factors of PUR. Methods : Case-control study. Six hours after vaginal delivery, urethral catheterisation was implemented for estimation of post-void residual bladder and diagnosis PUR. Patient data, including age, gestational age, body mass index, parity, mode of delivery, labour duration, perineal laceration or episiotomy, and fetal birth weight, were compared between women with and those without PUR to determine which obstetric factors that develop PUR. Results : Of the 365 participants recruited, 38 (10,67%) had PUR: 33 (9,27%) with covert PUR and 5 (1,4%) with overt PUR. Women with perineal laceration or episiotomy (p<0,05), instrument-assisted delivery (p<0,05), fi rst stage duration of labor more than 12 hours (p<0,05), second stage duration of labor more than one hour in multipara (p=0,041), and fetal birth weight more than 3800 grams (p<0,05) more prone to develop PUR. Conclusions : The incidence of PUR were associated with several obstetric risk factors: perineal laceration or episiotomy, instrument-assisted delivery, fi rst stage duration of labour more than twelve hours, second stage duration of labour more than one hour in multipara, and fetal birth weight more than 3800 grams. Keywords : postpartum urinary retention, risk factor, vaginal delivery. dalam terjadinya retensi urin pascasalin pervaginam. Metode : Penelitian kasus kontrol. Dilakukan pemeriksaan residu urine 6 jam pascasalin pervaginam untuk mengetahui kejadian retensi urine. Data pasien yang diambil berupa usia, usia gestasi, indeks massa tubuh, paritas, jenis persalinan, durasi kala I, durasi kala II, laserasi perineum / episiotomi, dan berat badan lahir bayi kemudian dibandingkan antara yang menderita retensi urin dan tanpa retensi urin pascasalin untuk mengetahui faktor risiko obstetri yang berperan. Hasil : Dari 365 sampel penelitian, 38 (10,67%) menderita retensi urin: 33 (9,27%) retensi urin asimptomatis dan 5 (1,4%) retensi urin simptomatis. Pasien dengan laserasi perineum / episiotomi (p<0,05), persalinan dengan bantuan instrumen (p<0,05), durasi persalinan kala I ≥ 12 jam (p<0,05), persalinan kala II ≥ 1 jam pada multipara (p=0,041), dan berat badan lahir bayi ≥ 3800 gram (p<0,05) memiliki risiko lebih tingi menderita retensi urin pascasalin pervaginam. Kesimpulan : Kejadian retensi urin pascasalin pervaginam berhubungan dengan beberapa faktor risiko obstetri yaitu laserasi perineum / episiotomi, persalinan dengan bantuan instrumen, durasi persalinan kala I ≥ 12 jam, persalinan kala II ≥ 1 jam pada multipara, dan berat badan lahir bayi ≥ 3800 gram. Kata kunci : faktor risiko, persalinan pervaginam, retensi urin