Wednesday, February 6, 2013

Retention of Urine During Pregnancy

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 RETENTION OF URINE DURING PREGNANCY

The pressure of the uterus upon the neck of the bladder may be so great as to render the emission of urine difficult or even impossible.

 Dysuria may thus arise at any period of pregnancy. 

It is, however, most frequent towards the end of gestation, probably owing to the uterus then falling forwards with greater force, and so compressing the neck of the bladder against the margin of the symphysis pubis.

 Anteversion and retroversion of the uterus likewise interfere with the normal performance of the functions of the bladder. If the retention depend simply on the pressure of the womb, and if the vesical coats have not lost their tone from long-con- tinued distension, the bladder may generally be voluntarily emptied by the woman lying upon her back with a bed-pan beneath the buttocks.

 But if this simple plan be found to fill, the catheter must be used. It has not very frequently happened, that from some error in diagnosis the bladder has been allowed to become so distended as to reach the umbilicus, giving rise to the greatest suffering. 

Of course rupture ultimately takes place unless proper treatment be adopted : and even if the urine be withdrawn, still there is no little fear of inflammation setting in, from the great irritation to which the coats have been subjected. 

WHAT HAPPENS DUE TO THE RETENTION OF URINE ? WILL THAT HARM MY BABY???


NO!!

In all those cases, therefore, where the practitioner finds, without the presence of any apparent cause
such symptoms as 
  1. pain at the lower part of the abdomen, 
  2. a frequent desire to pass small quantities of water, thirst, 
  3. loss of appetite, 
  4. heat of skin, 
  5. and a frequent pulse,

 he ought to direct his attention to the state of the bladder as it suggest a definite retention of urine. 

The Practitioner had better introduce a catheter unnecessarily, than fail to do so when it is urgently needed. But if he wish to temporize, he should at least see the quantity of urine which is passed in the twelve or twenty-four hours, so as to be sure that there is not merely a frequent dribbling from an over-distended bladder.

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