Advertisement

Archives of Gynecology and Obstetrics

, Volume 298, Issue 3, pp 529–535 | Cite as

How long women should be hospitalized after cesarean delivery

  • Ohad Gluck
  • Hadas Ganer-Herman
  • Jakob Bar
  • Michal Kovo
Maternal-Fetal Medicine

Abstract

Purpose

We aimed to investigate the impact of early versus late discharge following cesarean delivery (CD) on re-admission rate.

Methods

This is a retrospective cohort study of all CDs performed between 2013 and 2016. Patients who underwent CD between 01/13 and 12/14, were routinely discharged on postoperative day (POD) 3 (early discharge) and were defined as T1 group. Patients who had CD between 01/15 and 12/16 were routinely discharged on POD 4 (late discharge) and were defined as T2 group. Data on re-admission rate and postpartum complications were compared between the groups.

Results

As compared to the T2 group (n = 1856), less patients in the T1 group (n = 2020) had ≥ 2 previous CDs (13 vs. 15.6%, respectively; p = 0.02). The T1 group had shorter operative time as compared to the T2 group (p < 0.001). Postoperative complications and re-admission rates were similar between the groups. By logistic regression analysis model only intrapartum complications (RR = 7.87, CI 2.45–25.26, p < 0.001) and prolonged labor (RR = 3.68, CI 1.44–9.39, p = 0.006) were found to be independently associated with postpartum re-admission.

Conclusions

Early discharge after CD (POD 3) seems to be as safe as a more delayed discharge.

Keywords

Postpartum re-admission Postoperative complications Cesarean delivery Early postpartum discharge 

Notes

Author contributions

OG: manuscript writing and project development. HG-H: data analysis and data collection. JB: data collection and project development. MK: project development and manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

References

  1. 1.
    Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM, Torloni MR (2016) The increasing trend in caesarean section rates: global, regional and national estimates: 1990–2014. PLoS One (Internet) 11(2):e0148343.  https://doi.org/10.1371/journal.pone.0148343 CrossRefGoogle Scholar
  2. 2.
    MacDorman MF, Menacker F, Declercq E (2008) Cesarean birth in the United States: epidemiology, trends, and outcomes. Clin Perinatol 35(2):293–307CrossRefPubMedGoogle Scholar
  3. 3.
    Ye J, Betrán AP, Guerrero Vela M, Souza JP, Zhang J (2014) Searching for the optimal rate of medically necessary cesarean delivery. Birth (Internet) 41(3):237–244.  https://doi.org/10.1111/birt.12104 CrossRefGoogle Scholar
  4. 4.
    Jorgensen SK, Quinlan JD (2012) Cesarean delivery, obstetrics: normal and problem pregnancies (Internet), 7th edn. Elsevier Inc., New York, pp 425–443.  https://doi.org/10.1016/B978-0-323-32108-2.00019-6 CrossRefGoogle Scholar
  5. 5.
    Stamilio DM, Scifres CM (2014) Extreme obesity and postcesarean maternal complications (Internet). Obstet Gynecol 124(2, Part 1):227–232. http://www.ncbi.nlm.nih.gov/pubmed/25004353
  6. 6.
    Zuarez-Easton S, Zafran N, Garmi G, Salim R (2017) Postcesarean wound infection: prevalence, impact, prevention, and management challenges. Int J Womens Health 9:81–88CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Arlier S, Seyfettinoğlu S, Yilmaz E, Nazik H, Adıgüzel C, Eskimez E et al (2017) Incidence of adhesions and maternal and neonatal morbidity after repeat cesarean section. Arch Gynecol Obstet (Internet) 295(2):303–311.  https://doi.org/10.1007/s00404-016-4221-8 CrossRefGoogle Scholar
  8. 8.
    WHO (2013) Postnatal care of the mother and newborn 2013. World Heal Organ, pp 1–72. http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf
  9. 9.
    Bueno JAS, Romano MR, Teruel RG, Benjumea AG, Palacín AF, González CA et al (2005) Early discharge from obstetrics-pediatrics at the Hospital de Valme, with domiciliary follow-up. Am J Obstet Gynecol 193(3):714–726CrossRefGoogle Scholar
  10. 10.
    Liu S, Heaman M, Joseph KS, Liston RM, Huang L, Sauve R et al (2005) Risk of maternal postpartum readmission associated with mode of delivery. Obstet Gynecol (Internet) 105(4):836–842. http://www.ncbi.nlm.nih.gov/pubmed/15802414
  11. 11.
    Kehila M, Magdoud K, Touhami O, Abouda HS, Jeridi S, Marzouk S Ben et al (2016) Sortie précoce en post-partum: résultats et facteurs de risque de ré hospitalisation. Pan Afr Med J (Internet) 24:189. http://www.ncbi.nlm.nih.gov/pubmed/27795786
  12. 12.
    American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Association of Women’s Health O and NN (2016) Committee Opinion No. 666: optimizing postpartum care. Obstet Gynecol 127(6):e187–e192CrossRefGoogle Scholar
  13. 13.
    Brown S, Small R, Faber B, Krastev A, Davis P (2004) Early postnatal discharge from hospital for healthy mothers and term infants (Cochrane Review). In: The Cochrane Library Chichester. Wiley, UKGoogle Scholar
  14. 14.
    Brooten D, Roncoli M, Finkler S, Arnold L, Cohen A, Mennuti M (1994) A randomized trial of early hospital discharge and home follow-up of women having cesarean birth. Obstet Gynecol (Internet) 84(5):832–838. http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=7936522&retmode=ref&cmd=prlinks%5Cnpapers3://publication/uuid/552A4839-9A6C-465E-BC03-4CD8AD413E5E
  15. 15.
    Duff P (2012) Maternal and perinatal infection—bacterial obstetrics: normal and problem pregnancies (Internet), 7th edn. Elsevier Inc, New York, pp 1140–1155.  https://doi.org/10.1016/B978-1-4377-1935-2.00051-X CrossRefGoogle Scholar
  16. 16.
    Bayoumi YA, Bassiouny YA, Hassan AA, Gouda HM, Zaki SS, Abdelrazek AA (2016) Is there a difference in the maternal and neonatal outcomes between patients discharged after 24 h versus 72 h following cesarean section? A prospective randomized observational study on 2998 patients. J Matern Neonatal Med (Internet) 29(8):1339–1343.  https://doi.org/10.3109/14767058.2015.1048678 CrossRefGoogle Scholar
  17. 17.
    Nilsson I, Danbjørg DB, Aagaard H, Strandberg-Larsen K, Clemensen J, Kronborg H (2015) Parental experiences of early postnatal discharge: a meta-synthesis. Midwifery (Internet) 31(10):926–934.  https://doi.org/10.1016/j.midw.2015.07.004 CrossRefGoogle Scholar
  18. 18.
    Yang X-J, Sun S-S (2017) Comparison of maternal and fetal complications in elective and emergency cesarean section: a systematic review and meta-analysis. Arch Gynecol Obstet (Internet) 296(3):503–512.  https://doi.org/10.1007/s00404-017-4445-2 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyThe Edith Wolfson Medical Center (Affiliated with the Sackler School of Medicine, Tel Aviv University, Israel)HolonIsrael

Personalised recommendations