Evaluating The Effects of Enhanced Recovery After Surgery (ERAS) Protocol on Maternal Outcomes Following Caesarean Delivery

Document Type : Original Article

Authors

1 Obs&gyn -faculty of medicine- Mansoura University -Mansoura-egypt

2 Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

3 Mansoura Faculty of medicine Obst. and Gyn. Department

Abstract

Background: Enhanced recovery after surgery (ERAS) is a protocolised approach to perioperative care, aiming to enhance maternal recovery following surgery. It is accompanied by an improvement in maternal and neonatal outcomes, comprising diminished length of hospital stay (LOS), opioid need, postoperative pain (POP) scores, adverse events, higher maternal satisfaction, and enhanced breastfeeding (BF) success.
Aim: To evaluate the effectiveness of ERAS on maternal outcome after cesarean delivery (CD) in Mansura university hospital.
Methods: This was a clinical randomized controlled trial (RCT) conducted on a total of 100 pregnant ladies, divided into two equal groups: group A enrolled 50 patients treated with the ERAS protocol (study group), and group B enrolled 50 patients who were not treated with the ERAS protocol (control group). The outcomes included post-operative hospital length of stay, postsurgical adverse events such as postoperative nausea and vomiting (PONV), fever, hospital readmission, breastfeeding at discharge, and maternal satisfaction.
Results: Marked increase in ambulation time and LOS were recorded in group B compared to group A. Complications (nausea and vomiting) were markedly decreased in ERAS group compared to the control group. Pain score was markedly increased in the control group compared to intervention one. ERAS group was accompanied by significant increases in maternal satisfaction and maternal satisfaction compared to the control group. Breast feeding on discharge was more frequent among intervention than control group with significant difference between them.
Conclusion: The study found that the ERAS was able to significantly decrease postoperative pain (POP) and shortened LOS, without increasing the negative impact on the surgical outcome. As a result, strategies implementing the ERAS in CS seem to be efficient and safe.

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