Postoperative Period
Conditions
Keywords
Cesarean section, Postnatal Care
Brief summary
Cesarean section (CS) is a procedure with prolonged hospital stay compared to the routine for normal vaginal delivery in multiparas. The difference is caused mainly by postoperative pain but improvements in management of pain may change this situation and make early discharge possible. However, several aspects need to be considered. The aim of this project is to evaluate fast-track discharge for multiparas after elective CS concerning neonatal and maternal complications as well as the parents' sense of security and well-being. The study is a randomized controlled trial including 142 women allocated to either 1) the intention to discharge within 28 hours followed by a home visit or 2) standard discharge after at least 48 hours after elective CS. This study will be among the first evaluating fast-track discharge after CS in a European context. If a positive outcome is achieved, we expect that fast-track discharge can be implemented with improved quality and reduced costs in postnatal care following elective CS.
Interventions
PROCEDUREFast-track discharge
As described above
Sponsors
Herning Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Planned elective CS of multiparous women * Singleton pregnancy * Gestational age at least 37+0 weeks * Prepregnancy BMI \<35
Exclusion criteria
* Lack of consent * Women with no or little understanding of and ability to speak Danish * Expected maternal or neonatal complications after delivery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Parents' Postnatal Sense of Security | Measured one week after delivery | Using the validated PPSS-questionaire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Use of analgesia | During the first week postpartum | Daily consumption in mg of paracetamol, NSAID and opioid. |
| Mobilization | 5 days postpartum | Step count measured by an activity monitor (Fitbit Flex) |
| Breastfeeding | 6 months after delivery | Duration and extent of breastfeeding |
| Pain scores | During the first week postpartum | Measured by the patient in a questionnaire using numeric rating scale |
| Surgical complications | 28 days postpartum | Number of complications using the Clavien-Dindo Classification (1-5) |
| Complications in the postnatal period | 28 days postpartum | Number and type of complications using the ICD-10 classification |
| Contacts to the health care system | 28 days postpartum | Number of contacts and site of contacts (primary or secondary care) |
| Readmissions | 28 days postpartum | Number of readmissions and length of hospital stay in number of days |
Countries
Denmark
Outcome results
None listed