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Postpartum urinary retention — DRCOG MCQ

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HardPostnatal CarePostpartum urinary retentionDRCOG

A woman is 18 hours postpartum after epidural analgesia and instrumental delivery. She has suprapubic discomfort and has passed only small volumes despite drinking normally. Bladder scan shows 650 mL. What is the most likely diagnosis?

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Correct answer: E — Postpartum urinary retention

Large residual volume with discomfort after epidural and instrumental delivery indicates postpartum urinary retention. Cystitis may cause dysuria and frequency but would not explain a 650 mL residual immediately postpartum. Uterine atony presents with bleeding rather than bladder distension. The pearl is that retention can impair uterine contraction and should be managed promptly.

Reference: NICE NG194; RCOG postpartum bladder care guidance