Time-to-recovery After Cesarean Section Delivery Among Women who Gave birth through Cesarean Section at Hawassa University Comprehensive Specialized Hospital, south Ethiopia: A Prospective Cohort Study

Abstract

Background: Despite the progressive increment of caesarean section rates worldwide over the last decades; still the trend has not been accompanied by significant maternal or perinatal benefits. Moreover, information on the quality of the service, as measured by timely recovery, is scarce. This study assessed predictors of time-to-recovery after cesarean section delivery among women who gave birth through cesarean section at Hawassa University Comprehensive Specialized Hospital (HU-CSH), southern Ethiopia.Methods: Institution based prospective cohort study was conducted on 381 randomly selected women who gave birth by cesarean section in HU-CSH during the follow up period. Pre-tested structured questionnaire was used to collect the data. Data were analyzed using Kaplan Meir (KM) curve, Log rank test and Cox-Proportional hazard model. The outputs of the bivariable and multivariable Cox model are presented using Adjusted Hazard Ratio (AHR) with the respective 95% confidence intervals (CIs).Results: After a maximum of 19 days of stay, 96.2% [95%CI: 94.04-98.4%] of the women were early recovered. The overall median IQR) time of recovery was 2.00 (2, 3) days. The overall incidence density rate (IDR) of recovery in the cohort was 0.34 per Person-days or 2.38 per person-week. On the other hand the overall mean survival time was 3.07(95%CI: 2.75-3.40) days. Women who had ANC follow-up (AHR=1.49, 95%, CI: 1.05-2.10) and discharge from the wound site (AHR=0.13, 95%, CI: 0.03-0.56) were identified as significant positive and negative predictors of time-to- recovery after CS delivery respectively. Conclusion: This study showed that the rate of early recovery was high and is comparable to the global level figures. However, further improving preoperative maternal status, intraoperative follow up and post-operative care is needed to improve early recovery.