How long women should be hospitalized after cesarean delivery
We aimed to investigate the impact of early versus late discharge following cesarean delivery (CD) on re-admission rate.
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.
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.
Early discharge after CD (POD 3) seems to be as safe as a more delayed discharge.
KeywordsPostpartum re-admission Postoperative complications Cesarean delivery Early postpartum discharge
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.
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.
- 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 Google Scholar
- 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
- 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
- 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.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
- 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.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.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.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