Divya Pandey1, Sumita Mehta2, Anshul Grover3, Neerja Goel4. 1. Assistant Professor, Department of Obstetrics and Gynaecology, NDMC Medical College, Hindu Rao Hospital , Delhi, India . 2. Senior Specialist & HOD, Department of Obstetrics and Gynaecology, Babu Jag Jeevan Ram Hospital , Delhi, India . 3. Specialist, Department of Obstetrics and Gynaecology, Babu Jag Jeevan Ram Hospital , Delhi, India . 4. Director-Professor and Unit Head, Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital , Delhi, India .
Abstract
BACKGROUND:Routine placement of indwelling catheter preoperatively in Caesarean Section is being practiced without justified scientific evidence. AIM: To evaluate the effect of routine indwelling catheterization on the postoperative ambulation, morbidity and hospital stay in women undergoing Caesarean section. SETTINGS AND DESIGN: Case-Control study carried in a tertiary teaching hospital. MATERIALS AND METHODS: This study was carried over 150 women undergoing primary Caesarean section without any medical complication or pre-existing Urinary Tract Infections (UTI). The subjects were randomly allocated to 2 groups i.e. Group 1(Non-Catheterized; NC) and Group 2 (Catheterized for 24 hours postoperatively; C). Parameters noted were; duration of surgery, time of ambulation, postoperative voiding discomfort {graded as - no, mild, moderate-severe, by Visual Analog Scoring (VAS)}, incidence of UTI, postoperative urinary retention, need of postoperative antibiotics and duration of hospital stay. STATISTICAL ANALYSIS: Results were analysed using unpaired t-test. RESULTS: There was no significant difference in duration of surgery and postoperative urinary retention in both groups. However, it was seen that non-catheterized patients had significantly earlier ambulation, shorter hospital stay, took less time for first voiding, lesser voiding discomfort, less incidence of UTI and lesser use of postoperative antibiotics. CONCLUSION: The routine use of indwelling catheter in Caesarean section is unscientific and unnecessary. There should be selective rather than routine catheterization.
RCT Entities:
BACKGROUND: Routine placement of indwelling catheter preoperatively in Caesarean Section is being practiced without justified scientific evidence. AIM: To evaluate the effect of routine indwelling catheterization on the postoperative ambulation, morbidity and hospital stay in women undergoing Caesarean section. SETTINGS AND DESIGN: Case-Control study carried in a tertiary teaching hospital. MATERIALS AND METHODS: This study was carried over 150 women undergoing primary Caesarean section without any medical complication or pre-existing Urinary Tract Infections (UTI). The subjects were randomly allocated to 2 groups i.e. Group 1(Non-Catheterized; NC) and Group 2 (Catheterized for 24 hours postoperatively; C). Parameters noted were; duration of surgery, time of ambulation, postoperative voiding discomfort {graded as - no, mild, moderate-severe, by Visual Analog Scoring (VAS)}, incidence of UTI, postoperative urinary retention, need of postoperative antibiotics and duration of hospital stay. STATISTICAL ANALYSIS: Results were analysed using unpaired t-test. RESULTS: There was no significant difference in duration of surgery and postoperative urinary retention in both groups. However, it was seen that non-catheterized patients had significantly earlier ambulation, shorter hospital stay, took less time for first voiding, lesser voiding discomfort, less incidence of UTI and lesser use of postoperative antibiotics. CONCLUSION: The routine use of indwelling catheter in Caesarean section is unscientific and unnecessary. There should be selective rather than routine catheterization.
Authors: José Villar; Guillermo Carroli; Nelly Zavaleta; Allan Donner; Daniel Wojdyla; Anibal Faundes; Alejandro Velazco; Vicente Bataglia; Ana Langer; Alberto Narváez; Eliette Valladares; Archana Shah; Liana Campodónico; Mariana Romero; Sofia Reynoso; Karla Simônia de Pádua; Daniel Giordano; Marius Kublickas; Arnaldo Acosta Journal: BMJ Date: 2007-10-30