Micturition in the toilet compared with bedpan in laboring nulliparas: A randomized controlled trial

Kamarudin, Maherah and Chong, Wen Kiat and Hamdan, Mukhri and Ahmad Adlan, Aizura Syafinaz and Saaid, Rahmah and Tan, Peng Chiong (2022) Micturition in the toilet compared with bedpan in laboring nulliparas: A randomized controlled trial. BMC Pregnancy and Childbirth, 22 (1). ISSN 1471-2393, DOI https://doi.org/10.1186/s12884-022-05162-4.

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Background: Bladder overdistension in labor may lead to prolonged postpartum urinary retention. We hypothesized that nulliparas mobilizing to toilet is more likely to achieve satisfactory micturition. Methods: One hundred sixteen (58 in each arm) term nulliparas in labor with filled bladders were randomized to mobilizing to the toilet or using bedpan to micturate. Primary outcome was satisfactory micturition defined as ultrasound derived post-void bladder volume < 150 ml. Following unsatisfactory micturition, participants crossover to the opposed intervention. Participants were catheterized if after crossover, residual bladder volume was >= 250 ml. Results: Satisfactory micturition rates were 55/58 (95%) vs. 43/58 (74%) RR 1.28 95%CI 1.08-1.51 NNTb 4.8 95%CI 3.0-12.4 P = 0.008, failure to micturate 1/58 (2%) vs. 8/58 (14%) RR 0.13 95%CI 0.02-0.97 NNTb 8.3 95%CI 4.6-38.7 P = 0.047. After cross over following unsatisfactory bladder voiding, satisfactory micturition rates were 0/3 (0%) vs 13/15 (87%) P = 0.024, bladder catheterization rates were 3/58 (5%) vs. 2/58 (4%) RR 95%CI 1.5 (0.26-8.65) P = 0.648, maternal satisfaction with allocated intervention 55/58 (95%) vs. 9/58 (16%) RR 95%CI 6.1 (3.3-11.2) NNTb 95%CI 1.3 (1.1-1.5) P < 0.0001 and preference for mobilizing to the toilet if micturition was needed again during labor 55/58 (95%) vs. 53/58 (92%) for mobilizing to the toilet compared to bedpan use arms respectively. Labor and neonatal outcomes were similar. Conclusion: Satisfactory micturition was more frequently achieved with mobilization to the toilet than bedpan use. Women in both arms overwhelmingly prefer to mobilize to the toilet to urinate.

Item Type: Article
Funders: Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya
Uncontrolled Keywords: Nulliparas; Labor; Toilet; Bedpan; Micturition; Urination; Bladder voiding; Randomized trial
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Obstetrics & Gynaecology Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 14 Nov 2023 03:49
Last Modified: 14 Nov 2023 03:49
URI: http://eprints.um.edu.my/id/eprint/40722

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