Return to routine household and community functions following uncomplicated caesarean delivery: ultra-short versus traditional hospital-stay; a randomized controlled trial
摘要
Caesarean section is currently the commonest major surgical procedure in obstetrics, and duration of admission after this procedure varies widely among centres. There is a need to review the psychosocial and economic implications of recovery after Caesarean delivery, especially concerning return to household and community function.
AimTo determine the time of return to routine household and community functions; in the ultra-short stay post-operative management protocol, after uncomplicated Caesarean section; and compare with that of the traditional protocol.
MethodsA randomized controlled trial done in 3 centres [Federal Medical Centre Yenagoa (FMC-Y); Diete-Koki Memorial Hospital (DKMH); and Niger Delta University Teaching Hospital (NDUTH)] in Bayelsa state, South-South Nigeria, from April 2024 to April 2025. A total of 179 women who just had uncomplicated Caesarean delivery were randomized into the ultra-short stay (90) and traditional (89) groups. Recruitment was done in the recovery room immediately after uncomplicated Caesarean section. Women in the ultra-short stay (discharged home at 36–48 h post-operation) had minty chewing gums (‘menthos’) to chew for two hours within the first six hours after surgery; commenced ambulation, oral intake, and had their urethral catheters removed at 6–12 h post-operation. The traditional group (discharged home at 3–5 days post-operation) had conventional care (ambulation, initiation of oral intake and removal of urethral catheter at 12–24 h). Participants’ time of return to routine domestic/household and societal/community functions were recorded during the follow-up period. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.
ResultsThe mean number of days to return to routine household functions was 32.3 and 22.2 days, and for return to routine community functions was 79.8 and 40.9 days in the traditional and ultra-short stay protocols respectively. The ultra-short stay group had significantly quicker return to household functions (t = 2.32, p < 0.001), and community functions (t = 7.75, p < 0.001) than the traditional protocol group.
ConclusionWomen who had the ultra-short post-operative management protocol following uncomplicated Caesarean delivery returned to household and community functions faster than those who had the traditional hospital-stay protocol. Hospitals (especially in low resource settings) may adopt the ultra-short post-operative management protocol after uncomplicated Caesarean delivery, to enhance quicker return to function.
Trial registrationPan African Clinical trials Registry (PACTR), unique identification number PACTR202509662932971, 11 September, 2025.