Effect of early discharge after planned cesarean section on recovery and parental sense of security. A randomized clinical trial

Anne R Kruse, Finn F Lauszus, Axel Forman, Ulrik S Kesmodel, Marie B Rugaard, Randi K Knudsen, Eva-Kristina Persson, Niels Uldbjerg, Iben B Sundtoft, Anne R Kruse, Finn F Lauszus, Axel Forman, Ulrik S Kesmodel, Marie B Rugaard, Randi K Knudsen, Eva-Kristina Persson, Niels Uldbjerg, Iben B Sundtoft

Abstract

Introduction: In some European countries, discharge the day after planned cesarean section has become an accepted procedure. However, little is known about the patients' perception of early discharge. The aim of this study was to compare early discharge with standard care in relation to parental sense of security. Further, we evaluated postoperative pain, mobilization, and readmission.

Material and methods: We performed a randomized clinical trial including parous, singleton pregnant women with a planned cesarean section at term. The women were allocated to either discharge within 28 hours (intervention group) or after 48 hours (standard care group) following the cesarean section. Women discharged within 28 hours after cesarean section were offered a home visit by a midwife the following day. The primary outcome was the postnatal sense of security, which was reported by the woman and her partner in the "Parents' Postnatal Sense of Security" questionnaire 1 week postpartum. Secondary outcomes were pain score, use of analgesics, mobilization, readmission, and contacts with the healthcare system in the postoperative period.

Results: We included 143 women, of whom 72 were allocated to the intervention group and 71 were allocated to the standard care group. There were no differences in baseline characteristics. The two groups did not differ concerning the postnatal sense of security for the women (P = .98) or the postnatal sense of security for the partners (P = .38). We found no difference in pain scores, step count, use of analgesics, or number of contacts with the health-care system between the groups.

Conclusions: Parental postnatal sense of security is not compromised by discharge within 28 hours followed by a home visit compared with discharge after 48 hours after planned cesarean section among parous women.

Keywords: early ambulation; enhanced recovery after surgery; length of stay; pain; patient preference; postnatal care; postoperative; postoperative complications.

© 2020 Nordic Federation of Societies of Obstetrics and Gynecology.

References

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