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Postpartum urinary retention — DRCOG MCQ

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HardPostnatalPostpartum urinary retentionDRCOG

A 33-year-old woman is unable to pass urine 8 hours after instrumental birth with epidural analgesia. She has suprapubic discomfort and a palpable bladder. She is still on the postnatal ward. What is the most appropriate management?

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Correct answer: E — Arrange bladder catheterisation and postnatal bladder care

The best answer is “Arrange bladder catheterisation and postnatal bladder care”. Postpartum urinary retention requires prompt bladder decompression and a structured bladder-care plan to prevent overdistension injury. Waiting can worsen detrusor dysfunction. Antibiotics are not the first response unless infection is suspected. Discharge without resolving retention is unsafe. Postnatal symptoms must be separated into normal recovery, conditions suitable for community treatment and time-critical maternal deterioration. Haemodynamic compromise, severe hypertension, sepsis features, heavy bleeding or urinary retention require prompt escalation. Breastfeeding can usually continue during treatment for uncomplicated mastitis and should be supported rather than stopped reflexively.

Reference: NICE NG194: Postnatal care: https://www.nice.org.uk/guidance/ng194/chapter/Recommendations