When assessing a postpartum patient for urinary retention What signs and symptoms the nurse could observe?

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Page 2

Characteristics and quality assessment of the included articles.

Author (year)	Objective	Study design	Population	Number of participants	Maternal age (Mean ± SD)	Gestational weight (Weeks)	Risk estimate and 95% CI	The quality of studies
Pifarotti et al. (2014) [29]	Risk factors only for overt PUR	Retrospective case-control	Women who had a vaginal delivery	n = 11,108. 105 (0.8%) with PUR	Ns	Data not reported	Vacuum-assisted delivery (OR = 5.21, 95% CI = 1.5–17.1), uterine fundal pressure during the second stage of labor (OR = 4.95, 95% CI = 1.26–19.4)	Medium quality
Suzuki et al. (2018) [30]	PUR without epidural, including overt and covert PUR	Retrospective case-control	Singleton vaginal delivery	n = 2,449. 58 (2.4%) women with PUR compared with 2,391 women without PUR	32.2 ± 5.8 vs 31.8 ± 4.5 Ns	Data not reported	Nulliparity (adjusted OR = 2.39, 95% CI = 1.2–4.8, P = 0.01), instrumental delivery (adjusted OR = 3.53, 95% CI = 1.9–6.7, P < 0.01), and episiotomy (adjusted OR = 1.96, 95% CI = 1.0–3.8, P = 0.04)	Medium quality
Oh et al. (2016) [27]	Risk factors for acute PUR. Women undergo vaginal delivery with episiotomy without instrumental delivery	Case-control	Vaginal delivery, at least 20 years old, infant gestational age above 35 weeks, episiotomy, infant birth weight 2,300–4,500g	n = 206.one group: 98 patients with acute PUR after vaginal delivery without instrument use; the other group: 108 control patients matched by age and medical history	33.94 ± 3.69 vs 33.06 ± 3.75 Ns	38.89 ± 1.09 vs 38.99 ± 0.96 Ns	Medium vs mediolateral: (OR = 3.726, 95% CI = 1.826–7.603, P < 0.001), labor time (OR = 1.678, 95% CI = 1.592–1.776, P < 0. 001) and the presence of regional anesthesia (OR = 1.325, 95% CI = 1.227–1.515, P = 0.032)	High-quality
Cavkaytar et al. (2014) [31]	Risk factors for PUR, including overt and covert PUR	Case-control	Delivered term singletons vaginally after uncomplicated pregnancies	n = 234. 19 (8.1%) with PUR and 215 (91.9%) without PUR	27.79 ± 7.18 vs 26.38 ± 5.93 Ns	267.74 ± 8.96 vs 267.56 ± 7.46 (days) Ns	Prolonged duration of the second stage of labor (OR = 0.46, 95% CI for OR = 0.06–3.67, P < 0.001), presence of episiotomy (OR = 0.07, 95% CI for OR = 0.01–0.68, P = 0.022) and perineal laceration (OR = 97.09, 95% CI for OR = 7.93–1188.93, P < 0.001), and birth weight of >4000 g for the newborn (OR = 0.04, 95% CI for OR = 0.01–0.20, P < 0.001)	Medium quality
Erlangga et al. (2019) [33]	Determine the incidence and risk factors for PUR, including overt and covert PUR	Case-control	Normal or instrument-assisted vaginal delivery	n = 365. 38 (10.67%) had PUR: 33 (9.27%) with covert PUR and 5 (1.4%) with overt PUR	26.58 ± 5.93 vs 25.70 ± 6.09 Ns	38.71 ± 1.16 vs 38.26 ± 1.73 Ns	Perineal laceration or episiotomy (P < 0.05), instrument-assisted delivery (P < 0.05), first stage duration of labor more than 12 h (P < 0.05), second stage duration of labor more than 1 h in multipara (P = 0.041), and fetal birth weight more than 3,800 g (P < 0.05)	Low-quality
Polat et al. (2018) [34]	Risk factors for PUR, overt and covert	Retrospective case-control	Those older than 18 years and who delivered via vaginal birth were included in the study.	n = 560. 124 (22.1%) had PUR, including overt and covert PUR	27.90 ± 6.69 vs 27.19 ± 6.83 Ns	Data not reported	Third stage duration (OR = 1.025, 95% CI = 1.008–1.042, P = 0.003), time from birth to first void (OR = 1.103, 95% CI = 1.068–1.140, P = 0.001), and number of peripartum micturitions (OR = 0.759, 95% CI = 0.657–0.877, P = 0.001)	High-quality
Mulder et al. (2016) [26]	Identify independent delivery-related risk factors for covert PUR	Cross-sectional	Women after vaginal delivery with PVRV of more than 150 mL	n = 745. 347 (47%) were diagnosed with covert PUR (PVRV ≥150 mL)	31 (16–46) Mean (range)	Data not reported	Episiotomy (OR = 1.67, 95% CI = 1.02–2.71, P < 0.05), epidural analgesia (OR = 2.08, 95% CI = 1.36–3.19, P < 0.05), and birth weight (OR = 1.03, 95% CI = 1.01–1.06, P < 0.05).	High-quality
Kekre et al. (2011) [32]	Incidence of overt and covert PUR and risk factors for PUR, while listing the results only for covert PUR	Cross-sectional	Normal or instrumental vaginal delivery	n = 771. 84 (10.9%) had PUR: 82 (10.6%) with covert PUR and 2 (0.3%) with overt PUR	24.87 ± 3.93 vs 25.07 ± 4.05 Ns	Data not reported	Instrumental delivery (P = 0.03, OR = 1.194, 95% CI = 0.56–1.90), a duration of labor of more than 700 min	Medium quality
Choe et al. (2018) [28]	Investigating the range of postvoid residual urine volume after vaginal delivery and its association with various obstetric parameters	Cohort	Women who delivered vaginally. For those who were able to void within 6 h after delivery.	n = 155.PUR complicated approximately 7.7% of vaginal deliveries. 6 (3.85%) had overt retention and 6 (3.85%) had covert retention	29.5 (26.2, 32.8) vs 30.0 (27.0, 34.0) Median (quartile)	39.2 (38.1, 40.0) vs 39.2 (38.1, 40.0) Median (quartile)	Primiparity (P = 0.001), duration of active phase of labor (P = 0.001), duration of second stage of labor (P = 0.007), epidural analgesia (P = 0.004), episiotomy (P < 0.001), instrumental delivery (P = 0.004), and degree of perineal pain (P < 0.001).	High- quality