Enhanced Recovery after Cesarean Section (CS) versus Conventional Care in a Lower Middle-Income Country: A Randomized Controlled Trial

Abstract

Background: Enhanced recovery after surgery (ERAS) has been tested in a wide variety of surgeries with promising outcomes. However, there is a need for a standardized, evidence-informed approach to both the development of new ERAS ® Society guidelines, and the adaptation and revision of existing guidelines. Developing countries have limited resources and deserve every effort to improve economic status. Aim of the Study: to evaluate perinatal maternal outcomes of ERAS versus routine care protocols in women undergoing elective cesarean section (CS) in a lower middle-income country with limited resources ranked as a third most country performing CS worldwide using a multidisciplinary team (MDT) management. Design: A prospective randomized Controlled Trial. Setting: Outpatient department (OPD) and labor ward at the Woman's Health hospital, Assiut University, Egypt. Participants: Healthy pregnant women planned for elective CS (300 women) were randomly divided into a study group offered ERAS protocol and a control group offered regular care. Results: Repeat CS was the main indication of elective CS in both groups without significant difference (89 cases (59.3%) and 75 cases (50%) in both groups respectively). Other indications included cephalopelvic disproportion in 17 cases (11%) and 19 cases (12.6%), placenta previa in 28 (18.6%) and 34 (22.6%) cases, DM in 11 (7%) and 19 (12.6%) cases, and others in 5 (0.3%) and 3 (2%) cases in both groups respectively. The study group took much less time to eat and walk. It had significantly lower pain levels and postoperative problems, as well as much greater women's satisfaction and a shorter hospital stay (p = 0.001

Assessment of Women' Satisfaction of Routine Care Provided Pre and Post Cesarean Section

“…The importance of continuous education and training in healthcare settings has been recognized for its ability to improve patient care and enhance the performance of healthcare professionals (da Silva et al, 2023). Mustafa et al (2022) emphasize the significance of ongoing education and training for healthcare professionals to stay up-to-date in their field and provide evidence-based care. Given the rapid progress of technology, it is crucial for healthcare professionals to stay informed about the latest tools and techniques in their field (Thibault, 2020).…”