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Prospective 3D ultrasonographic evaluation of immediate postpartum urine retention volume in 100 women who delivered vaginally

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Abstract

Our objective was to determine the reproducibility and validity of urine retention volumes measured by 3D ultrasonography (3D-US) 2 h postpartum. This was a longitudinal prospective study of 100 women who delivered vaginally. Each woman underwent five successive urine retention measurements with the Bladder Scan 2 h after vaginal delivery, followed by transurethral catheterization to determine the real volume. The reproducibility of only the last four scan values was analyzed with an intraclass correlation coefficient, and that of determinations 4 and 5 with a Bland–Altman plot. The validity of the device was similarly evaluated using the mean four-scan and real values. Pearson’s correlation coefficient was calculated and a least-trimmed squares robust linear-regression model was used. All tests were two-sided with a 5% α risk. Results showed that 3D-US measurements were highly reproducible, with an intraclass correlation coefficient of 0.974 (95% CI:0.964–0.981). 3D-US also accurately estimated the real urine volume (intraclass correlation coefficient 0.924; 95% CI:0.888–0.949), but tended to underestimate by about 6.8%. The between-technique Pearson correlation coefficient was 0.94 (P<0.0001) and the regression analysis gave an R 2 of 0.914. Urine retention volumes exceeded 500 ml in 55 women, and 1 l in 7. We concluded that 3D-US was reliably able to measure postpartum urine retention volume.

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Abbreviations

3D:

Three-dimensional

SUI:

Stress urinary incontinence

US:

Ultrasonography

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Acknowledgments

The authors would like to thank all the labor room nurses who participated in the study. They also express their gratitude to Janet Jacobson for translating this manuscript.

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Authors and Affiliations

  1. Service de Gynécologie–Obstétrique, Hôpital Rothschild, 33. bd de Picpus, 75571, Paris Cedex, France

    F. Demaria, N. Amar, X. Fritel, P. Madelenat & J. L. Benifla

  2. Département de Biostatistique et Informatique Médicale, Hôpital Saint-Louis, 75010, Paris, France

    D. Biau & R. Porcher

  3. Service de Rééducation Neurologique et Explorations Périnéales, Hôpital Rothschild, 75012, Paris, France

    G. Amarenco

  4. Service de Gynécologie–Obstétrique, Hôpital Bichat, 75018, Paris, France

    P. Madelenat

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  1. F. Demaria
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  2. N. Amar
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  3. D. Biau
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  4. X. Fritel
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  6. G. Amarenco
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  7. P. Madelenat
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  8. J. L. Benifla
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Corresponding author

Correspondence to J. L. Benifla.

Additional information

Editorial Comment: The authors provide strong evidence for the criterion validity and the test–retest reliability of bladder scan ultrasound measurements of residual urine volume during the immediate postpartum period in women who delivered vaginally under lumbar epidural or spinal anesthesia. It is unclear from the manuscript when it would be necessary to evaluate bladder volumes, residual or otherwise, during the immediate postpartum period in such women. The nursing staff or physicians can most often assess bladder volume by palpation in patients who have decreased bladder sensation because of afferent nerve blocks. This approach is neither invasive nor costly, compared to catheterization or bladder scanning.

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Demaria, F., Amar, N., Biau, D. et al. Prospective 3D ultrasonographic evaluation of immediate postpartum urine retention volume in 100 women who delivered vaginally. Int Urogynecol J 15, 281–285 (2004). https://doi.org/10.1007/s00192-004-1159-3

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  • DOI: https://doi.org/10.1007/s00192-004-1159-3

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