This study aims to compare the routine use versus non-use of urethral catheterization in women undergoing first elective cesarean section as regard to intraoperative and postoperative complications
This randomized controlled trial will be done at Ain Shams University Maternity One hundred and seventy pregnant women scheduled for first elective CS attending at outpatient clinic will be chosen after complete history and physical examination to determine eligibility for inclusion after taking their consent with full explanation of the study including potential benefits and risks. The study population will be randomized using computer sequence program in 1:1 ratio. Allocation of every patient to one of the studied groups will be done using opaque envelops. The studied groups will be either Group C or Group N For both groups * A written consent will be taken. * Full history to exclude medical problems that need special care. * Full history to exclude UTI or recurrent UTI during pregnancy. * A single dose of 2 gm cefazolin will be given IV pre-incision for preoperative antibiotic prophylaxis (Sullivan et al., 2007). * midstream urine samples will be collected preoperative to exclude UTI and 24 hours postoperatively after giving the instructions to the patients (washing hands and genitals ,pass some urine into the toilet then without stopping catch some urine in a sterile container ) to be analyzed for presence of UTI
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
170
85 women undergoing first elective CS will be catheterized immediately preoperatively using Foley's catheter by applying catheterization precautions.
Ain Shams University Maternity Hospital.
Cairo, Egypt
Presence of UTI
midstream urine samples were collected 24 hours postoperatively after giving the instructions to the patients and tested for presence of UTI. These fresh non-centrifuged urine samples were collected and tested for leukocyte esterase and nitrite using (Convergys urine matrix 10, Germany) strips. Nitrite will be considered positive if there is change in color of dipstick from colorless towards pink within 60 seconds. Leukocyte esterase will be considered positive if there is change in color from off-white towards purple within 2 minutes
Time frame: 24-h postoperative
Operative duration
The time taken for surgery from skin opening to complete skin closure,
Time frame: intraoperative
Bladder injury incidence.
accidental bladder injury during operation
Time frame: intraoperative
Intraoperative need of urethral catheter in N group
intraoperative need of catheter for any reason
Time frame: intraoperative
Ambulation time
from intraoperative skin opening time till the patient is able to move.
Time frame: intraoperative
Postpartum hemorrhage
identified when there is costant trickling f blood or repeated soakage of valval pad within 5 minutes
Time frame: first postoperative day
Urinary retention
defined as no spontaneous micturition \>24 hours after cesarean delivery
Time frame: first postoperative day
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Patient satisfaction
using four point likert scale from 1-4 (as 1 = not satisfied, 2 = partial satisfied, 3 = satisfied, 4 = very satisfied).
Time frame: second postoperative day morning