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.Clinical Study of Cesarean Section.
Jong Kuk BAECK ; Jung Yun PARK ; Tae Bon KOO ; Il Soo PARK
Korean Journal of Perinatology 2000;11(1):54-60
No abstract available.
Cesarean Section*
;
Female
;
Pregnancy
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 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
7.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
8.Study on modification of the method for cesarean at the Department of Obstetrics and Gynecology, Da Nang Hospital between February 2004 and October 2004
Ho Chi Minh city Medical Association 2005;10(3):135-138
A randomize, controlled trial was conducted at the Department of Obstetrics and Gynecology, Da Nang Hospital between February 2004 and October 2004. 180 cesarean section cases, who met selection criteria (first cesarean section, gestational age ≥37 weeks, single pregnancy, same surgeon), were randomly assigned into 2 groups: modification group with modified Misgav Ladach method and Pfannelstiel group with Pfannelstiel incision. Results: Mean time of extraction of the newborn was 2.6±0.8 minutes in the modification group and 5.7±0.9 minutes in the Pfannelstiel group (p = 0). Mean duration of operation was 33.4±2.1 minutes in the modification group compared with 43.5±3.2 minutes in the Pfannelstiel group (p = 0). One hematoma (1.1%) was seen with the modification group versus 9 (10%) in the control group (p<0.05). The number of analgestic doses required during postoperative period was significantly lower in the modification group (1.3±0.6 versus 1.9±0.7 vials of pethidin; p<0.000001). There were no significant differences between the two groups in maternal age, gestational age, and indication of operation, Apgar scores and duration of hospitalization
Cesarean Section
;
Epidemiology
9.Determinants of cesarean section in Ho Chi Minh city
Ho Chi Minh city Medical Association 2005;10(5):261-264
Study on 1260 women aged from 19 to 45 years old: 180 cases of elective cesarean section (CS), 360 cases of emergency CS, and 720 cases of vaginal delivery (the control group) at Hung Vuong Hospital in order to evaluate the effects of medical and socioeconomic factors on the decision of CS. Results: economic status didn’t affect on the indication of emergency CS, but the rate of elective CS in women with favorable economic level increased by 3.64 times. Seeking examinations at an obstetric hospital itself may have potential risk of pregnancies, the risk of emergency CS increased 16.99 times and the risk of elective CS raised 5.67 times. In addition, some factors can affect on the decision of CS such as 1st born child, having expected for pregnancy, having request for CS, fetal sex, etc
Cesarean Section
;
Epidemiology
10.Clinical analysis on cesarean section.
Seong Nyun WEE ; Hak Lim LEE ; Eun Joo MOON ; Soo Hyun LIM ; Se Yong LEE ; Chul KIM
Korean Journal of Obstetrics and Gynecology 1991;34(2):198-208
No abstract available.
Cesarean Section*
;
Female
;
Pregnancy