Women undergoing planned caesarean section Pregnancy and Childbirth
Conditions
Interventions
Participants will be randomised into two arms, the self-emptying of the bladder arm or the indwelling bladder catheter arm.
Patients randomised to self-emptying of the bladder arm wil
Sponsors
University Malaya Medical Centre
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1. Planned caesarean section 2. Age 18 years and above 3. Gestational age (supported by dating ultrasound) =37 weeks 4. Singleton pregnancy 5. Reassuring fetal heart rate tracing
Exclusion criteria
Exclusion criteria: 1. Patients with evidence of urinary tract infection or recurrent antenatal UTI 2. Presence of large (>4 cm) ovarian or uterine masses 3. Anticipated pelvic adhesion 4. Anticipated difficult surgery or prolonged surgery time such as cases of placenta previa or accreta spectrum 5. Patients with severe pre-eclampsia or any other conditions requiring postoperative monitoring of urinary output
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Post-partum urinary retention (PPUR) rate measured using bladder scan at hospital discharge 2. Maternal satisfaction with their allocated peri-caesarean bladder care measured using the Verbal Numeric Rating Scale (VNRS) at discharge | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Intraoperative outcomes measured using case report form – data collected after caesarean section is done: 1.1. Surgical field impairment (Yes/No) 1.2. Distressed catheterization (need for catheterization during caesarean section) (Yes/No) 1.3. Operative blood loss (in milliliters) 1.4. Bladder injury (Yes/No) 1.5. Duration of surgery (in minutes) 2. Postoperative outcomes measured using case report form at 24 hours post-surgery: 2.1. Urinary tract infection with urine culture and sensitivity test at 24 hours post-surgery 2.2. Lower urinary tract symptoms (LUTS) measured with the International Prostate Symptom Score (IPSS) questionnaire upon discharge 2.3. Time to first bowel flatulence 2.4. Time to first satisfactory breastfeeding experience 2.5. Time to first satisfactory urination 2.6. Time to first satisfactory ambulation 2.7. 11-point 0-10 Verbal Numeric Rating Scale (VNRS) pain score at first post-caesarean urination 2.8. Length of hospital stay post-surgery (from operation to discharge) 2.9. 11-point 0-10 VNRS pain score upon movement at discharge | — |
Countries
Malaysia
Outcome results
None listed