000			03405nam a22003137a 4500
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001			OB 2020 0005
003			PILC
005			20240720153215.0
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040			_beng _cFEU-NRMF MEDICAL LIBRARY _erda
041			_aenglish
050			_aOB 2020 0005
245			_aA Continuum of postpartum birth related complications / _cAyessa A. Chin.
260			_aFairview, Quezon City: _bDepartment of Obstetrics and Gynecology, FEU-NRMF, _c2020.
300			_bphotos; _c(in folder) _ewith flash drive (soft copy).
336			_2rdacontent _atext
337			_2rdamedia _aunmediated
338			_2rdacarrier _avolume
504			_aIncludes appendices and bibliographical references.
520			_aAbstract: Bladder overdistention injuries are common in the early puerperium. These are most closely related with a variety of factors such as duration of labor, weight of the fetus, impaired expulsive efforts, anesthesia, failure to empty the bladder before bearing down, the Kristeller maneuver, failure of pelvic floor relaxation, and long second stage of labor which all contribute singly or in combination leading to postpartum urinary retention (PPUR). Of 234 women undergoing vaginal delivery, 19 (8.1%) had postpartum urinary retention. However, an occult bladder injury from a normal vaginal delivery is a rare complication with an incidence of around 1 in every 126,000 people. Spontaneous bladder injuries can range from a minute tear or a full laceration and can present immediately or after a few days following a vaginal delivery. A high index of suspicion is warranted in such cases. A case of 32-year-old Gravida 2 Para 2 (2002) who underwent normal spontaneous delivery in another institution two weeks prior, came in complaining of progressive abdominal distention and decreasing urine output followed subsequently by anuria within the last 24 hours. On evaluation, however, there were numerous other conditions identified. Clinical assessments from all managing specialties were episiorrhaphy wound dehiscence, vaginal laceration, anemia acute kidney injury probably from from obstructive nephropathy, and multiple electrolyte imbalance. A small bowel obstruction and rectovaginal fistula were also considered. An occult bladder injury was highly based on the history and clinical course of the patient. This was managed conservatively along with all the other conditions identified which ultimately resolved each problem except for the fistula which will be repaired at an optimal time. Vaginal delivery is not without any risks and complications, with occult bladder injuries being one of them. Bladder injuries have a variety of presentation but not all lead to urosepsis and not all warrant surgical intervention. At times, prolonged bladder catheterization is curative. Suspicion is by meticulous history taking combined with the overall clinical picture of the patient, aided with laboratory and imaging studies. In this era of preventive intrapartum and postpartum care cannot be overemphasized to health care workers handling deliveries of women.
521			_aRESDOG
650			_aoccult bladder injury
650			_apostpartum urinary retention
650			_arectoperineal fistula
650			_aperineal wound dehiscence
650			_anormal spontaneous delivery
700			_aChin, Ayessa A., MD. _eauthor
942			_2lcc _cRU