Fear of childbirth during the third trimester of pregnancy may increase the risk of subsequent emergency cesarean section.

Fear of childbirth during the third trimester of pregnancy may increase the risk of subsequent emergency cesarean section.

The purpose of this study was to investigate the prevalence of postpartum urinary retention in women after vaginal delivery and to determine whether parturients with retention develop voiding problems later. During a 3-month period, all parturients in the catchment area of the University Hospital, Lund, were investigated 3 days after delivery, residual volume being measured by ultrasonography. All those with postpartal retention were contacted 4 years after delivery, when they were reexamined by ultrasonography and asked to fill in a questionnaire regarding urinary problems. In all, 539 women were scanned post partum, and 8 (1.5%) had a residual volume exceeding 150 ml (range 156–320 ml). Retention was more common among primiparae after instrumental delivery or epidural analgesia. The symptoms were normalized spontaneously within a few days in all cases. At follow-up 4 years later, the prevalence of urinary symptoms was not higher than that in the general population. Ultrasonography to detect urinary retention does not seem to have any place in the normal postpartal care. However, extended supervision may be appropriate in parturients receiving epidural analgesia or in those submitted to instrumental deliveries.

Aim. To study possible detrimental maternal and neonatal effects of immersion in warm water during labor. Design. Prospective randomized controlled bathing during first stage of labor vs no bathing. Setting. Obstetrical departments at a university hospital and two central hospitals. Primary end-point. Referral of newborns to NICU. Material and methods. Randomization took place by means of sealed opaque envelopes at each delivery unit. Preconditions for participation in the study were: singleton parturient wishing to bathe, a gestational duration of at least 35 weeksπ0 days, a planned vaginal delivery, normal admission test, regular contractions and cervix dilated to at least 3-4 cm. Parturients randomized to the 'no bath' control group were allowed to use a shower. Rupture of the membranes was not a contra-indication to participation. Those excluded from randomization were women with intra-uterine growth retardation, meconium-stained amniotic fluid, or in the event that the tub was occupied by another randomized parturient. Main results. On average, parturients stayed in the tub for 50-60 min. No significant difference was seen regarding the referral rate to NICU among 612 cases vs 625 controls, OR 0.8; 95% CL 0.2, 3.1. The OR for epidural analgesia was 1.0; 95% CL 0.8, 1.3. Nor was any significant difference seen in the rate of perineal tear grade III-IV (OR 1.3), instrumental delivery (OR 1.1), cesarean section (OR 1.8), or maternal post partum stay on the ward. During the neonatal period, no significant difference was seen in the number of newborns with Apgar Ͻ7 at 5 min (4 vs 5), neonatal distress (OR 2.2) or tachypnéa (OR 1.0). Conclusion. In the present study no negative effects of bathing during labor could be discerned. The results indicate that expectant mothers wishing to bathe during labor may do so without jeopardizing their own, or their newborns' wellbeing after birth.

An anonymous questionnaire was used to interview 946 premenopausal women (age 29-52 years), previously either hysterectomized or laparoscopically sterilized, concerning disorders of the urinary tract. Of the 750 (79.3%) women that responded, 307 (40.9%) admitted to some degree of urinary disorder. The prevalence of urinary disorders was 170/415 (40.9%) for the women with a previous supravaginal or total hysterectomy and 137/335 (40.8%) for the women in the sterilization group. Of the responding women 85 (11.3%) experienced a urinary loss sufficient to necessitate the wearing of a sanitary napkin or change of underclothing several times a day.