Walking to a better future? Postoperative ambulation after cesarean delivery and complications: A prospective study

Abstract

Objective To assess the correlation between maternal mobility after cesarean delivery and postoperative morbidity. Methods A prospective study was conducted in a tertiary hospital among patients after cesarean delivery. The women were recruited after surgery and before ambulation. Each participant received an accelerometer and routine instructions for mobilization. The patients were asked to wear the accelerometer constantly. It was collected at discharge. Electronic files were reviewed and patients’ outcomes were analyzed. The Mann–Whitney U test was used to compare groups and a receiver operating characteristic curve was calculated for the threshold of number of steps. Results Data were analyzed for 199 patients, among which 107 (54.4%) deliveries were urgent and 90 (45.6%) were elective. The median number of steps was higher for multiparous women compared to nulliparous women (P = 0.035). Patients who developed complications after discharge walked significantly less during their hospitalization compared to those who did not. There was a trend toward increased risk for in‐hospitalization complications among patients who walked less while hospitalized. A threshold of more than 9716 steps per hospitalization was found to be associated with fewer post‐discharge complications. Conclusion There is a significant correlation between the extent of ambulation after cesarean delivery and fewer postoperative complications.

Utilization of Wearable Pedometer Devices in the Perioperative Period: A Qualitative Systematic Review

“…Engel et al 15 found that patients who developed postdischarge complications up to 6 weeks after cesarean delivery (including surgical site infection, postpartum hemorrhage, and endometritis) had significantly lower total step counts during their hospital stay (8719 vs 6974 steps; P = .04), but there was no significant difference between postoperative step count and in-hospital complications (8612 vs 7554 steps; P = .09). Incidentally, sleep length and quality were also measured; these did not demonstrate a significant association with postoperative complication rate.…”

Activity Restrictions After Gynecologic Surgery

“…Numerous studies report the importance of early, moderate physical exercise after cesarean delivery as measured by pedometers. [26][27][28] Further studies promoting enhanced physical activity in the postoperative period with objective quantitative measures would be helpful in elucidating the role that physical activity might have on postoperative recovery.…”

The effects of intrathecal morphine on urinary bladder function and recovery in patients having a cesarean delivery – A randomized clinical trial

“…Likewise, indwelling urinary bladder catheterization is commonly used in women after CD, which represents a risk for nosocomial urinary tract infection [10,11]. Apart from the infectious risk, the autonomy and selfesteem of the mother are affected by a long-lasting bladder catheter [12].…”