TITLE:
The Effect of Early versus Traditional Hospital Discharge on Activities of Daily Living for Women Undergoing Elective Cesarean Section. An Observational Cohort Study
AUTHORS:
Ahmed Mohammed Elmaraghy, Rasha Elhoseny Yehia, Ahmed Hamdy Naguib
KEYWORDS:
Cesarean Section, Early Discharge, Katz Index of Independence in Activities of Daily Living
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.3,
March
31,
2023
ABSTRACT: Background: Cesarean
section is one of the most common surgeries performed worldwide and its
consequences and complications represent a major public health concern. The
policy of enhanced recovery after surgery has been implemented after cesarean
section to optimize perioperative care. Enhanced recovery also aims to reduce
the length of hospital stay, which might imply substantial healthcare savings.
Rising hospital costs are one of the factors in early discharge. Patients
& Methods: This was a prospective cohort study. 158 patients met the
inclusion criteria of the study, 81 patients were discharged after 48 hours and
77 patients were discharged after 24 hours. All patients received the same postoperative
care and instructions. All the study participants received a phone call 1, 3,
and 5 days after discharge to objectively assess the activities of daily living
through Katz index of independence in activities of daily living. All patients
were offered a postpartum visit 1 week after discharge during which the wound
was assessed by the Southampton wound assessment scale. Moreover, other
maternal complications such as mastitis, puerperal sepsis, or pyelonephritis
were assessed and cases who were readmitted were documented. Initiation of
successful breastfeeding and neonatal readmission were reported as well. Results: 158 patients met the inclusion/exclusion criteria of the study. There was no
significant difference between the two arms of the study regarding baseline
characteristics. Katz index of independence showed that the resumption of
activities of daily living after CS was similar in both arms of the study on
days 1, 3 and 5 after discharge. Time till the passage of flatus and stool
after the cesarean section was significantly shorter among the early discharge
arm (9.31 VS 14.68, p value Conclusion: The policy of early discharge can be adopted in low-risk
cases scheduled for elective uncomplicated CS provided that the mother and the
neonate are in good general condition and proper instructions regarding red
flag manifestations are given.