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Prolapse, Urogynecology & Infections

Question
3 out of 30
 

A 21-yrs-old has difficulty voiding 6 hrs postpartum. The least likely cause is which of the following? (DNB Dec 2012)



A Preeclampsia

B Infusion of oxytocin after delivery

C Vulvar hematoma

D Urethral trauma

Ans. A

Preeclampsia

1. An inability to void often leads to the diagnosis of a vulvar hematoma. Such hematomas are often large enough to apply pressure on the urethra.

2.

a. Pain from urethral laceration is another reason women have difficulty voiding after delivery.

b. Both general anesthesia, which temporarily disturbs neural control of the bladder, and oxytocin, which has an antidiuretic effect, can lead to an over distended bladder and an inability to void.

c. In this case an indwelling catheter should be inserted and left in for at least 24 h to allow recovery of normal bladder tone and sensation.

d. Preeclampsia often leads to edema, which generally leads to diuresis postpartum.

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