2.Comparison of post-operative outcomes between enhanced recovery after surgery versus standard operative protocol among cesarean delivery mothers at a tertiary hospital.
Lourdes Therese S. Reyes ; Charisse P. Guerrero
Journal of the Philippine Medical Association 2021;100(1):29-50
This Randomized Controlled Trial sought to
determine whether mothers who underwent
Cesarean delivery had better postoperative
outcomes when subjected to the Enhanced
Recovery After Surgery (ERAS) protocol compared
to mothers who also underwent Cesarean section
as a mode of delivery but were under the Standard
operative protocol.
The research concentrated on evaluating
the postoperative outcomes of the patients in the
study through the following factors: length of
hospitalization, efficiency and cost-effectiveness of
hospital expenses, early resumption of diet and
early ambulation, breastfeeding initiation and
continuation.
A total of 72 subjects were included in the
study. Two were not included due to conversion to
general anesthesia. Thirty two (44.4%) were
randomized to the ERAS protocol while 40 (55.6%)
patients were randomized to Standard
postoperative procedure. Demographic
characteristics were recorded and comparable
between the two groups. Mothers randomized to
the ERAS protocol had significantly shorter length
of stay compared to mothers in the standard
operative procedure with a mean of 53.01 hours
(2.21 days) and 78.86 hours (3.29 days)
respectively. Mothers randomized to the ERAS
protocol spent significantly lower hospitalization
cost compared to mothers in the standard operative
procedure. There was no significant difference
noted in the proportion of mothers with fever
between the two groups (p=0.25). Mothers
randomized to the ERAS protocol had significantly
lower post-operative pain compared to mothers in
the standard operative procedure. The time from
end of OR until general liquids was also significantly
shorter among mothers randomized to the ERAS
protocol compared to mothers in the standard
operative procedure. Similarly, the time from end of
OR to flatus and bowel movement was also
significantly shorter among mothers randomized to
the ERAS protocol compared to mothers in the
standard operative procedure. The time from end of
OR to removal of foley catheter and time to void
after foley catheter removal was also significantly
shorter among mothers randomized to the ERAS
protocol compared to mothers in the standard
operative procedure. Finally, there was a significant
difference noted in the length of time from end of
OR to breastfeeding as proven by all p value of 0.02.
Mothers randomized to the ERAS protocol had
significantly shorter length of time from end of OR
to breastfeeding compared to mothers in the
standard operative procedure with a mean of 30.67
hours and 43.09 hours respectively.
Ultimately, the study concentrated on Emergency or
Elective Cesarean deliveries of Low risk patients as
well as patients with controlled gestational or overt
diabetes mellitus, thyroid disorders in euthyroid
state, and hypertensive disorders not complicated
with eclampsia. This study did not seek to
generalize the benefit of ERAS protocol on all
Cesarean deliveries.
ERAS protocol showed better postoperative
outcomes compared to the Standard
operative protocol in terms of shorter length of
hospital confinement, lower cost of hospitalization,
no occurrence of post-operative infections and
complications, shorter length of time from operation
to diet progression tolerance, passage of flatus,
bowel movement, shorter length of time from end of
OR to removal of foley catheter and time to void and
finally shorter time from operation to initiation of
breastfeeding and continuation.
Cesarean Section
3.Uterocutaneous fistula: A rare complication of cesarean section
Sampath Gnanarathne ; Ashani Ratnayake ; Ayodhya Kariyawasam
Philippine Journal of Obstetrics and Gynecology 2025;49(1):74-76
A uterocutaneous fistula is an abnormal tract between the endometrium of the uterus and the skin. It is a rare but significant postcesarean section complication. This is a case of a 39-year-old female who presented with cyclical bleeding from her cesarean section scar during menstruation over the past 4 years. The assessment revealed a discharging sinus in the scar and an acutely anteverted, fixed uterus. Symptoms persisted despite medical treatment for the provisional diagnosis of endometriosis. The diagnosis was updated as uterocutaneous fistula based on a computed tomography scan of the pelvis and abdomen and a hysterosalpingogram. The fistula was surgically excised, and a hysterectomy was performed. This report elaborates on the rare presentation, diagnosis, and definitive surgical management. The surgical management resulted in a successful resolution, highlighting the importance of choosing the appropriate treatment modality while adhering to a patient-centered approach.
Cesarean Section
4.A Case of HELLP Synfrome Developed after Cesarean Section.
Sang Gi SEO ; Jae Ho LEE ; Yoon Seok YUM ; Chu Yeop HUH
Korean Journal of Perinatology 2000;11(3):349-353
No abstract available.
Cesarean Section*
;
Female
;
Pregnancy
5.Clinical and statistic analysis of cesarean section: change in recent 10 years.
Keun Young BAE ; Hae Suck JUNG ; Young Chul CHOI ; Hae Jong KIM ; Kwang Soo KEE ; Hun Jung IM
Korean Journal of Obstetrics and Gynecology 1993;36(7):1099-1110
No abstract available.
Cesarean Section*
;
Female
;
Pregnancy
6.Clinical analysis of cesarean section.
Chul Won JHANG ; Kyong Ran JU ; Seong Ho CHOO ; Bong Soo OH
Korean Journal of Obstetrics and Gynecology 1992;35(6):827-834
No abstract available.
Cesarean Section*
;
Female
;
Pregnancy
7.Clinical analysis on cesarean section.
Jae Chern SONG ; Hyun Kyung KIM ; Man Chul PARK ; Joo Hyun NAM ; Won Sop OH ; Jwa Koo CHUNG
Korean Journal of Obstetrics and Gynecology 1993;36(7):1300-1307
No abstract available.
Cesarean Section*
;
Female
;
Pregnancy
8.Preliminary study on duration of cesarean section in the National Hospital of Gynecology and Obstetrics
Journal of Vietnamese Medicine 2005;314(9):10-14
The study included 71 pregnant women underwent cesarean section in the National Hospital of Gynecology and Obstetrics between January and May 2004. Results: average duration of a cesarean section is 31 minutes and 1 second, the mean time of transversal laparotomy is 28 minutes and 15 seconds. In cases of transversall incision, the duration is 37 minutes and 9 seconds. The mean time required for newborn extraction is 5 minutes and 10 seconds. In cases of transversal incision, this duration is 4 minutes and 36 seconds. If the incision was made in white line below navel, the duration is 6 minutes and 29 seconds
Cesarean Section
;
Pregnant Women
9.Report 88 cesarean sections with single-layer uterine suture
Journal of Vietnamese Medicine 2005;314(9):32-35
Study on 88 cases of cesarean section at Obstetric Department, Bach Mai Hospital between January and October, 1992. There was no complication in procedures of single-layer uterine suture using catgut thread made in Vietnam. This procedure has more advantages than 2-layer uterine suture, including such shorten operation time, better preservation of the lower uterine
Cesarean Section
;
Sutures
10.Preliminary remarks about infection in cesarean section in Institute of Protection of Mother and Newborn
Journal of Vietnamese Medicine 2005;310(5):1-4
Randomized study of 251 patients experienced cesarean section in Institute of Protection of Mother and Newborn in October 1995. Result: 79.9% cases of cesarean section had unruptured amnia or had ruptured amnia less than 6 hours, only 1.6% of cases had ruptured amnia over 24hours. 35 cases of cesarean had old cesarean scar (13.9%). Among 151 cases of cesarean, 19 cases (7.6%) were infection. The most common infection was postoperative fever and the least common was abdominal infection. 95% of patients were treated by 2 types of antibiotic combination after operative
Cesarean Section
;
Infection