Document Detail


Hospital discharge on the first compared with the second day after a planned cesarean delivery: a randomized controlled trial.
MedLine Citation:
PMID:  23168750     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare patient satisfaction and exclusive breastfeeding rates for patients discharged from the hospital on postcesarean day 1 (next day) or day 2.
METHODS: Healthy women admitted for planned cesarean delivery were randomized to day 1 or day 2 discharge. Postoperative assessment for suitability for discharge was based on defined criteria. Primary outcomes were patient satisfaction with their discharge timing assessed at 2 weeks and reported exclusive breastfeeding at 6 weeks after discharge. Analyses were based on intention-to-treat and per-protocol discharge.
RESULTS: Of the 360 women randomized, results of 170 compared with 172 and 142 compared with 148 (day 1 compared with day 2) were available for intention-to-treat and per-protocol analyses, respectively. Nine women fulfilled discharge criteria but declined day 1 discharge, and 12 women allocated to day 2 discharge took their own discharge on day 1. Intention-to-treat analysis showed that satisfaction with discharge protocol was expressed by 148 of 170 (87.1%) compared with 147 of 172 (85.5%) (relative risk 1.1, 95% confidence interval [CI] 0.6-2.1, P=.75) and exclusive breastfeeding (at 6 weeks) was reported by 76 of 170 (44.7%) compared with 77 of 172 (44.9%) (relative risk 1.0 95% CI 0.7-1.5 P=.99 for day 1 compared with day 2 discharges, respectively). All secondary outcomes assessed at up to 6 weeks after discharge including unscheduled maternal or infant medical consultations, rehospitalizations, maternal antibiotic use, and maternal well-being, anxiety, and depression status, were similar. Results on per-protocol analysis were also similar.
CONCLUSION: Day 1 discharge compared with day 2 discharge after a planned cesarean delivery resulted in equivalent outcomes.
CLINICAL TRIAL REGISTRATION: ISRCTN Register, ISRCTN.org, ISRCTN27523895.
Authors:
Peng Chiong Tan; Mat Jin Norazilah; Siti Zawiah Omar
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  120     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-21     Completed Date:  2013-02-08     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1273-82     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN27523895
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MeSH Terms
Descriptor/Qualifier:
Adult
Anxiety / psychology
Breast Feeding / psychology
Cesarean Section / psychology*
Depression / psychology
Female
Humans
Infant, Newborn
Maternal Welfare / psychology
Patient Discharge*
Patient Readmission
Patient Satisfaction*
Pregnancy
Treatment Outcome
Comments/Corrections
Comment In:
Obstet Gynecol. 2013 Apr;121(4):877-8   [PMID:  23635696 ]
Obstet Gynecol. 2013 Apr;121(4):878   [PMID:  23635697 ]

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