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Cesarean section (CS) is a procedure with prolonged hospital stay compared to the routine for normal vaginal delivery in multiparas. The difference is caused mainly by postoperative pain but improvements in management of pain may change this situation and make early discharge possible. However, several aspects need to be considered.
The aim of this project is to evaluate fast-track discharge for multiparas after elective CS concerning neonatal and maternal complications as well as the parents' sense of security and well-being.
The study is a randomized controlled trial including 142 women allocated to either 1) the intention to discharge within 28 hours followed by a home visit or 2) standard discharge after at least 48 hours after elective CS.
This study will be among the first evaluating fast-track discharge after CS in a European context. If a positive outcome is achieved, we expect that fast-track discharge can be implemented with improved quality and reduced costs in postnatal care following elective CS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fast-track discharge | Experimental | Intention to discharge within 28 hours after elective cesarean section including a home visit by a nurse or midwife from the postnatal ward. |
|
| Standard discharge | No Intervention | Discharge at least 48 hours after elective cesarean section. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fast-track discharge | Procedure | As described above |
|
| Measure | Description | Time Frame |
|---|---|---|
| Parents' Postnatal Sense of Security | Using the validated PPSS-questionaire | Measured one week after delivery |
| Measure | Description | Time Frame |
|---|---|---|
| Pain scores | Measured by the patient in a questionnaire using numeric rating scale | During the first week postpartum |
| Use of analgesia | Daily consumption in mg of paracetamol, NSAID and opioid. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Byrjalsen, MD | Department chairman | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Obstetrics and Gynecology | Herning | 7400 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34100558 | Derived | Jones E, Stewart F, Taylor B, Davis PG, Brown SJ. Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database Syst Rev. 2021 Jun 8;6(6):CD002958. doi: 10.1002/14651858.CD002958.pub2. |
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| During the first week postpartum |
| Mobilization | Step count measured by an activity monitor (Fitbit Flex) | 5 days postpartum |
| Breastfeeding | Duration and extent of breastfeeding | 6 months after delivery |
| Readmissions | Number of readmissions and length of hospital stay in number of days | 28 days postpartum |
| Surgical complications | Number of complications using the Clavien-Dindo Classification (1-5) | 28 days postpartum |
| Complications in the postnatal period | Number and type of complications using the ICD-10 classification | 28 days postpartum |
| Contacts to the health care system | Number of contacts and site of contacts (primary or secondary care) | 28 days postpartum |