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Quality of Recovery After Unplanned and Planned Cesarean Deliveries - an Application of ObsQoR-10

Completed
Conditions
Quality of Recovery
Interventions
Other: Obstetric Quality of Recovery-10 (ObsQoR-10©) Scoring Tool
Registration Number
NCT04907292
Lead Sponsor
Samuel Lunenfeld Research Institute, Mount Sinai Hospital
Brief Summary

In Canada, 29.1% of annual births are via cesarean deliveries (CD). The literature shows that almost 24% of CDs are unplanned. Existing evidence suggests that unplanned cesarean delivery, compared to elective cesarean, may be associated with poor maternal recovery, longer postpartum hospital stays and more opioid requirements after surgery. Since the establishment of the Enhanced Recovery After Cesarean protocols, specific care pathways have been implemented with the aim of optimizing recovery after CD and to reduce the costs to the health care system. However, the majority of unplanned cesarean receive the same postoperative anesthetic, obstetric and nursing care as the elective CDs.

Looking at the actual information about maternal recovery after unplanned CD, the investigators found that there is a paucity of literature examining this topic utilizing validated, patient-oriented quality of recovery tools. Recently, Obstetric Quality of Recovery-10 scoring tool (ObsQoR-10), a new patient-focused outcome instrument for postpartum recovery, it has been validated for all types of deliveries, in the inpatient setting. ObsQoR-10 tool aims to measure quantitatively functional recovery at 24 hours postpartum. It includes 10 questions on a 0 to 10 scale, aimed at pain management, the adverse effects of narcotics and the perception of recovery by the patient.

The aim of this study is to determine the quality of recovery from unplanned cesarean deliveries compared to planned ones using a validated tool for recovery after cesarean delivery (ObsQoR-10 tool).

The investigators hypothesize that quality of recovery as measured by the Obs-QoR10 for unplanned cesarean deliveries will be lower than the planned CDs.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
112
Inclusion Criteria
  • Women aged 18 years old and over
  • Term singleton pregnancy
  • Undergoing planned or unplanned caesarean delivery at Mount Sinai Hospital
  • Patients who have given informed written consent
Exclusion Criteria
  • Patients who have refused, are unable to give or have withdrawn consent
  • Patients unable to communicate fluently in English
  • Patients with American Society of Anesthesiologists (ASA) classification of 4 or greater
  • Patients scheduled to have a classical vertical incision
  • Patients undergoing cesarean hysterectomy
  • Patients with history of chronic pain, chronic use of analgesic drugs, or history of opioid or intravenous drug abuse
  • Patients who have refused neuraxial anesthesia, or those in whom it is contraindicated.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Unplanned Cesarean deliveryObstetric Quality of Recovery-10 (ObsQoR-10©) Scoring ToolPatients who have an unplanned Cesarean delivery at Mount Sinai Hospital
Planned Cesarean deliveryObstetric Quality of Recovery-10 (ObsQoR-10©) Scoring ToolPatients who have an elective Cesarean delivery at Mount Sinai Hospital
Primary Outcome Measures
NameTimeMethod
Obstetric Quality of Recovery-10 (ObsQoR-10) score 24 hours24 hours

ObsQoR-10 score at 24 hours after surgery for both planned and unplanned cesarean deliveries. There are 10 questions, and the results are tabulated out of 100. The higher the overall score out of 100, the better quality of recovery a patient is experiencing.

Secondary Outcome Measures
NameTimeMethod
Opioid consumption - 48 hours48 hours

Total opioid consumption within 48 hours post cesarean

Pain Score (VAS) - 48 hours48 hours

Verbal analogue scale (VAS) of 0-10, where 0= no pain and 10=worst pain imaginable, at 48 hours post cesarean delivery

Pain Score (VAS) - 24 hours24 hours

Verbal analogue scale (VAS) of 0-10, where 0= no pain and 10=worst pain imaginable, at 24 hours post cesarean delivery

Obstetric Quality of Recovery-10 (ObsQoR-10) score 7 days7 days

ObsQoR-10 score at 7 days after surgery for both planned and unplanned cesarean deliveries. There are 10 questions, and the results are tabulated out of 100. The higher the overall score out of 100, the better quality of recovery a patient is experiencing.

Hospital discharge - questionnaire, 24 hours24 hours

At 24 hours post cesarean, patients will be asked the question "Are you ready to be discharged from the hospital? Yes or No"

Obstetric Quality of Recovery-10 (ObsQoR-10) score 48 hours48 hours

ObsQoR-10 score at 48 hours after surgery for both planned and unplanned cesarean deliveries. There are 10 questions, and the results are tabulated out of 100. The higher the overall score out of 100, the better quality of recovery a patient is experiencing.

Hospital discharge - questionnaire, 48 hours48 hours

At 48 hours post cesarean, patients will be asked the question "Are you ready to be discharged from the hospital? Yes or No"

Opioid consumption - 24 hours24 hours

Total opioid consumption within 24 hours post cesarean

Trial Locations

Locations (1)

Mount Sinai Hospital

🇨🇦

Toronto, Ontario, Canada

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