الفهرس 
CESAREAN DELIVERYOnly 14 pages are availabe for public view
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Abstract
Background: Enhanced recovery after cesarean delivery (ERAC) is perioperative
care program to fasten patients recovery. ERAC protocols intended to improve
patient outcomes and fasten return to normal function before surgery by
standardization of practice at all stages: preoperative, intraoperative and
postoperative.
Aim of the study: The aim of this study was to evaluate whether the
implementation of enhanced recovery after cesarean (ERAC) would decrease the
length of hospital stay and pain score and improve postoperative patient
satisfaction and breastfeeding and its effect on postoperative complications and
hospital readmission.
Patients and methods: 86 pregnant women undergoing uncomplicated elective
cesarean delivery were enrolled in this study. patients were randomized to two
groups: 43 patients in the Enhanced recovery after cesarean delivery (ERAC)
group and 43 patients in the standard care group. Enhanced recovery after cesarean
involved multiple evidence-based interventions and were divided into the three
major phases of patient care: antepartum, intrapartum and postpartum. The primary
outcome was the length of hospital stay after cesarean delivery. Secondary
outcomes included pain medication requirements and pain scores, breastfeeding
and first time of start breastfeeding, maternal satisfaction, postoperative
complications and hospital readmission.
Results: Enhanced recovery after cesarean delivery was associated with a highly
significantly shorter length of hospital stay when compared to standard care (pvalue <0.001). There was a highly significant reduction in pain scores at 2h, 4h, 6h
and 12h in the ERAC group in comparison to standard care group (p-value
<0.001). There was no statistically significant difference between the two groups
of studied participants regarding breastfeeding (p-value=0.5). However, there was
statistically highly significant difference between the two groups of studied
participants regarding the time of starting breastfeeding (p-value <0.001). The
participants were more significantly satisfied in the ERAC group than in the
standard group (p-value>0.001).
Conclusion: Implementation of enhanced recovery after elective cesarean delivery
(ERAC) pathway lead to significantly shorter length of hospital stay, lower pain
scores, better patient satisfaction and earlier start of breastfeeding.