关键词: 初产妇, 产后尿潴留, 低频脉冲电刺激, WAFF运动, 危险因素, 疗效

Abstract: Objective To explore the high-risk factors of postpartum urinary retention in primiparas and evaluate the efficacy of low-frequency pulsed electrical stimulation combined with WAFF exercise for this condition.Methods A total of 160 primiparous women with postpartum urinary retention who were admitted to the First Hospital of Hebei Medical University,Baoding Maternal and Child Health Hospital,and Shijiazhuang Huayao Hospital,North China Medical and Health Group from March 2022 to June 2025 were selected as the research subjects and assigned to the postpartum urinary retention group(n=160).Meanwhile,160 primiparas without postpartum urinary retention during the same period were randomly selected at a 1∶1 ratio and assigned to the non-urinary retention group(n=160).Additionally,the primiparas in the urinary retention group were divided into the control group(n=80)and the observation group(n=80)according to different treatment methods.The clinical data of all patients were recorded,and the influencing factors were analyzed using the Logistic regression model.A nomogram prediction model was constructed based on the characteristic variables and evaluated.The clinical efficacy,clinical indicators,urodynamics,and pelvic floor function were compared between the two groups of primiparas with urinary retention.Results The multivariate analysis results showed that neonatal weight(OR=5.834),second stage of labor duration(OR=1.143),forceps-assisted delivery(OR=3.744),oxytocin use(OR=2.489),and episiotomy(OR=2.102)were independent risk factors for postpartum urinary retention in primiparas(all P<0.05).A nomogram model was constructed based on the results of Logistic regression analysis,with an area under the curve(AUC)of 0.863(95%CI:0.824—0.903).The calibration curve suggested that the model had good predictive performance.After treatment,the total effective rate of the observation group was significantly higher than that of the control group(95.00% vs.78.75%,P<0.01).The first voiding time,first voided volume,and post-void residual urine volume in the observation group were significantly better than those in the control group(all P<0.01).The maximum urinary flow rate,maximum urethral closure pressure,and detrusor pressure in the observation group were significantly higher than those in the control group(all P<0.01).Additionally,the vaginal systolic pressure,resting pressure,and systolic duration in the observation group were significantly higher than those in the control group(all P<0.01).Conclusion Neonatal macrosomia(excessive birth weight),prolonged second stage of labor,forceps-assisted delivery,oxytocin use,and episiotomy are independent risk factors for postpartum urinary retention in primiparas.The nomogram model constructed based on these factors has good predictive value.Low-frequency pulsed electrical stimulation combined with WAFF exercise can effectively alleviate the symptoms of postpartum urinary retention in primiparas,promote the recovery of bladder function and pelvic floor muscle function.As a safe and effective intervention method,it is worthy of clinical promotion and application.

Key words: primipara, postpartum urinary retention, low-frequency pulsed electrical stimulation, WAFF exercise, risk factor, therapeutic effect