Evaluation of the Absence of Intraoperative Bladder Catheterization in Case of Planned Cesarean Section
Evaluation of the Absence of Intraoperative Bladder Catheterization in Case of Planned Cesarean Section: Multicenter Non-inferiority Randomized Controlled Trial
University Hospital, Montpellier
550 participants
Jan 20, 2025
INTERVENTIONAL
Conditions
Summary
The hypothesis of this trial is that the absence of systematic bladder catheterization in patients performing spontaneous urination in the hour preceding the planned cesarean section under spinal anesthesia would not lead to more bladder heterocatheterization for postpartum urinary retention (RUPP) in the 24 hours post-cesarean section than systematic intraoperative bladder catheterization up to 2 hours post-surgery.
Eligibility
Inclusion Criteria4
- Adult patient
- Patient admitted for a planned cesarean section after 34 weeks under spinal anesthesia
- Single or twin pregnancy
- Unscarred or with one or two scars of the uterus
Exclusion Criteria18
- Positive urine test strip showing a presence of nitrites or leukocytes, the day before the surgery suggesting asymptomatic bacteriuria
- Emergency Caesarean
- Scheduled Caesarean section with intervention delayed beyond 3 p.m. for service organization reasons
- Epidural anesthesia
- Contraindication to spinal anesthesia (uncorrected hypovolemia; blood coagulation disorders; sepsis or severe inflammation at the puncture site; neurological deficit; migraine pattern; spinal cord disease; spinal malformation; febrile syndrome)
- ASA (American Society of Anesthesiologists) score ≥ 4
- Placental insertion abnormality (placenta previa and/or accreta)
- Medical indication for monitoring of diuresis
- Oliguria or renal failure
- Indication for use of intrathecal clonidine during scheduled cesarean section
- History of bladder surgery or surgical urological pathology during pregnancy (JJ catheter in place)
- History of complex abdominal surgery
- Impossibility or absence of obtaining free, informed and written consent, after a period of reflection
- Patient not affiliated or beneficiary of a national health insurance system
- Patient under legal protection, under guardianship or under curatorship
- Patient having participated in interventional research on a drug within 3 months before inclusion
- Patient participating in another interventional research
- Patient in exclusion period determined by another study
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Interventions
Patients will be asked to urinate by spontaneous urination in the hour before the cesarean section with a cytobacteriological urine examination (ECBU) carried out. An ultrasound check by Bladderscan of the post-void residue will be carried out as soon as the patient will be installed on the intervention table. In the event of post-void residue of more than 150 ml, favoring urinary infections, the patient will be excluded from the research.
After implementation of loco-regional analgesia by spinal anesthesia, the patient will be positioned, with a perineal toilet and installation of a bladder catheter type Foley ch. 16.
Locations(2)
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NCT06357546