Cateterismo intermitente versus contínuo e diferenças na evolução do trabalho de parto: Revisão sistemática e meta-análise

Reis, Inês; Cunha, Sara; Martins, Matilde; Sousa, Luísa; Seixas, Adérito; Rasteiro, Cátia

doi:10.1055/s-0041-1740209

Inês Reis Address for correspondence Inês Reis, Specialist in Gynecology and Obstetrics, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal (e-mail: inesreis@hotmail.com).

Serviço de Ginecologia e Obstetrícia do Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

http://orcid.org/0000-0003-4570-7491

Sara Cunha

Serviço de Ginecologia e Obstetrícia do Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

http://orcid.org/0000-0002-9132-542X

Matilde Martins

Serviço de Ginecologia e Obstetrícia do Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

http://orcid.org/0000-0003-4686-8860

Luísa Sousa

Serviço de Ginecologia e Obstetrícia do Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

http://orcid.org/0000-0002-5171-0104

Adérito Seixas

Escola Superior de Saúde, Fundação Fernando Pessoa, Porto, Portugal

LABIOMEP, INEGI-LAETA, Faculty of Sports, University of Porto, Porto, Portugal

http://orcid.org/0000-0002-6563-8246

Cátia Rasteiro

Serviço de Ginecologia e Obstetrícia do Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal

Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal

http://orcid.org/0000-0002-6920-5296

Address for correspondence Inês Reis, Specialist in Gynecology and Obstetrics, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal (e-mail: inesreis@hotmail.com).

Conflicts of Interests

The authors have no conflict of interests to declare.

Contributors

All authors participated in the concept and design of the study, as well as in the analysis and interpretation of data, and draft or revision of the manuscript; they have also approved the manuscript as submitted. All authors are responsible for the research.

Author, Year

Sample characterization

Intervention protocol

Rated outcomes

Results

Evron, 2008 (Evron et al., 2008)⁴4 Evron S, Dimitrochenko V, Khazin V, Sherman A, Sadan O, Boaz M, et al. The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial. J Clin Anesth. 2008;20(08): 567–572. Doi: 10.1016/j.jclinane.2008.06.009
https://doi.org/10.1016/j.jclinane.2008....

n = 209(IC 109; CC 1 00)

IC group: 25 ±4 years; 164± 6 cm; 74 ± 11 kg; 40 ± 2 weeks; 3 ± 1 cm when epidural; 105 ± 196 minute of membrane rupture; 55% with oxytocic acceleration; newborns with 3,140 ±450 gr CC group: 26 ±4 years; 164± 6 cm; 78 ± 13 kg; 40 ± 2 weeks; 3 ± 1 cm when epidural; 105 ±203 minutes of membrane rupture; 67% with oxytocic acceleration; newborns with 3,1 29 ±460 gr

IC group: clinical evaluation for the diagnosis of urinary retention every 90 minutes; if urinary retention is suspected - attempted spontaneous urination and bladder emptying if necessary CC group: catheterization after neuroaxis analgesia

Primary outcomes: 2nd stage of labor length; anesthetic dose Secondary outcomes: postpartum urinary retention; postpartum urinary infection

2nd stage of labor longer in the CC group (105 ± 72 minute,) compared with the IC group (75 ±52 minute).

Greater use of anesthetic in the CC group in the first and second stages of labor.

Better mobility according to the Bromage scale in the IC group

Rivard, 2012 (Rivard et al., 2012)⁶6 Rivard C, Awad M, Liebermann M, DeJong M, Massey SM, Sinacore J, et al. Bladder drainage during labor: a randomized controlled trial. J Obstet Gynaecol Res. 2012;38(08):1046–1051. Doi: 10.1111/j.1447-0756.2011.01837.x
https://doi.org/10.1111/j.1447-0756.2011...

n = 138(IC 66; CC 72)

IC group: 28.7 years; 2 previous pregnancies, 38 weeks and 2 days, 60% spontaneous deliveries

CC group: 27.6 years; 2 previous pregnancies, 38 weeks and 2 days, 50% spontaneous deliveries

After determining the need for bladder emptying

IC group: Bladder emptying by catheter every 2–4 hours

CC group: catheterization until expulsion period

Primary outcome: time interval until delivery

Secondary outcomes: nursing team preference; costs; delivery mode

No significant differences in duration of labor or cost.

Nursing team preference for continuous catheterization

Wilson, 2015 (Wilson et al., 2015)⁸8 Wilson BL, Passante T, Rauschenbach D, Yang R, Wong B. Bladder management with epidural anesthesia during labor: a randomized controlled trial. MCN Am J Matern Child Nurs. 2015;40(04): 234–242, quiz E17–E18. Doi: 10.1097/NMC.0000000000000156
https://doi.org/10.1097/NMC.000000000000...

n = 123 (IC68; CC 55)

IC group: 26.16 ±4.76 years; 39.74 ±1.06 weeks; 4.69 ± 1.33 cm with 91.41 % when epidural; 30.99% of induced births; 43.66% with oxytocic acceleration; newborns with 3,445 ±453.73 gr

CC group: 25.87 ±4.66 years; 39.77 ±1.22 weeks; 4.52 ± 1.35 cm with 88.23% when epidural; 34.62% of induced births; 46.15% with oxytocic acceleration; newborns with 3,486 ± 445.08 gr

IC group: periodic evaluation (maximum of 6 in 6 hours) and attempted spontaneous urination and intermittent bladder emptying whenever this is not possible (continuous tube placement after 2 catheterizations)

CC group: catheterization after neuraxial analgesia

Outcomes

Duration of the 2nd stage of labor, incidence of UTI

No differences regarding the duration of the 2nd stage of labor.

Higher rate of cesarean sections in the CC group

Suleiman, 201 7 (Suleiman et al., 2017)⁷7 Suleiman A, Mruwat-Rabah S, Garmi G, Dagilayske D, ZelichoverT, Salim R. Effect of intermittent versus continuous bladder catheterization on duration of the second stage of labor among nulliparous women with an epidural: a randomized controlled trial. Int Urogynecol J Pelvic Floor Dysfunct. 2018;29(05): 691–696. Doi: 10.1007/s00192-017-3357-9
https://doi.org/10.1007/s00192-017-3357-...

n = 184(IC=94; CC = 90)

IC group: 27.9 ±4.5 years; BMI 23.9 ±4.9 Kg/ m2; 39.3 ± 1.3 weeks; 3.4 ± 1.1 cm when epidural; 58.5% of induced births; newborns with 3310.2 ±423.1 gr

CC group: 27.0 ±4.6 years; BMI 23.8±4.9 Kg / m2; 39.5 ± 1.3 weeks; 3.3 ± 1.2 cm when epidural; 60% of induced births; newborns with 3,264.7 ±442.2 gr

After epidural and inability to spontaneously urinate

IC group: evaluation every 2 hours or when necessary with bladder emptying if unable to urinate or in case of urinary retention

CC group: catheterization up to the 2nd stage of labor

Primary outcome: Duration of the 2nd stage of labor

Secondary outcomes: type of delivery, duration of the 3rd stage of labor, postpartum hemorrhage, urinary retention, bacteriuria, Apgar score, umbilical artery pH

No differences for included outcomes.

[1] Address for correspondence Inês Reis, Specialist in Gynecology and Obstetrics, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal (e-mail: inesreis@hotmail.com).

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