Urodynamic investigations are used to investigate bladder function and dysfunction in women with urinary symptoms, the most common being urinary incontinence. Guidance from the National Institute for Health and Clinical Excellence covers much of when investigations should be performed. Women are often anxious and embarrassed when they attend the tests. Recognition of the artificial test conditions and the feelings of the woman are crucial to optimising the chances of reproducing symptoms. Before cystometry, written information explaining the test should be provided with the appointment letter or when the woman attends the clinic. The information should include instructions on providing a urine sample in a sterile container, bladder chart and questionnaires and advice to come with a comfortably full bladder. Women who are using drugs to treat lower urinary tract dysfunction should normally stop using the medication for an appropriate period of time before the investigation.

This chapter presents an overview of both maternal and infant birth injuries, considering their etiology, potential methods of avoidance, and critiques of current obstetric practices. The more significant maternal complications of parturition include birth canal lacerations, episiotomy extensions, other perineal or rectal injuries, and various degrees of intrapartum and postpartum hemorrhage. Certain clinical settings predispose to birth injury, including labor stimulation, dystocia/macrosomia, preterm delivery, the diagnosis of acute fetal jeopardy from any cause, and instrumental or cesarean delivery. Superficial maternal birth canal injuries such as soft-tissue abrasions, ecchymoses, or small lacerations are common enough to be considered normal. Vaginal and cervical lacerations, urinary tract dysfunction, uterine infection, uterine rupture are other specific maternal birth injuries discussed in the chapter. The most common direct fetal injury after maternal blunt trauma is a cranial fracture.