Is day-case caesarean section feasible? Evaluating an ultrashort-stay post-operative protocol at the University of Medical Sciences Teaching Hospital, Ondo state, south-western Nigeria

Abstract

Background: Caesarean section (CS) is the most common major obstetric procedure. Research towards improving its safety and cost-effectiveness is imperative. This study aimed to evaluate an ultrashort-stay post-caesarean section management protocol (USPCP) on eligible patients at a teaching hospital in Ondo state.

Methodology: This is a prospective study conducted over a nine-month period involving 28 consecutive patients who underwent routine CS and were subjected to USPCP. Data obtained included obstetric characteristics inputted into an Excel spreadsheet for analysis. The USPCP was implemented for each patient from the 6th hour post-op to achieve a visual analogue pain score of ≤ 3, normal dietary intake, full ambulation and breastfeeding capabilities within 12 to 24 hours. Thereafter, wound inspections were conducted on an outpatient basis by the 6th day post-op.

Results: Patients that underwent elective CS accounted for 82% of total number. The mean gestational age (in weeks), surgery duration (minutes), blood loss (ml) and postop stay (hours) were 37.8, 38.7, 610.7 and 32.5, respectively. All but one patient had satisfactory wound healing while another was lost to follow-up.

Conclusion: The USPCP led to the successful management and discharge of patients within an average time of less than 36 hours. Day case caesarean sections are feasible.