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Enhanced Recovery After Surgery for Emergency Caesarean Deliveries

Not Applicable
Completed
Conditions
Pregnancy Related
Registration Number
NCT03518463
Lead Sponsor
Mbarara University of Science and Technology
Brief Summary

Caesarean section (CS) constitutes a large proportion of the total surgical volume in low-income countries. This rate comes with challenges including surgical complications, shortage of beds, and consequently long waiting time for operations and high costs. These have led to the adoption of ERAS in developed countries in a bid to save costs by reducing hospital length of stay without compromising the health of the mother and her baby.

Detailed Description

CS is the most common major surgery at Mbarara Hospital (56.2%). This rate comes with challenges including surgical complications, shortage of beds, and consequently long waiting time for operations. Enhanced recovery programs are composed of preoperative, intraoperative and postoperative strategies combined to form a multi-modal pathway. ERAS requires a multidisciplinary team of anesthetists, surgeons and nurses for successful implementation and realization of its advantages. ERAS has been seen to reduce duration of hospital stay, complications and costs. Although many of the elements of enhanced recovery after surgery are similar, it has not been tested in emergency CS and there is limited data about its applicability in low income settings like Uganda where 95% of CS are emergencies. The aim of this study was to assess the impact of ERAS protocols following emergency caesarean delivery in a low resource setting.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
160
Inclusion Criteria
  • We included women who were ASA 1 and 2 mothers who were delivering by emergency caesarean section using spinal anesthetic technique.
Exclusion Criteria
  • Exclusion criteria included refusal to consent, pregnancy complicated by preeclampsia, antepartum hemorrhage, malaria, gestational diabetes mellitus, physical disability that would prevent postoperative mobilization and mental illness precluding comprehension of protocols.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Length of hospital stayMeasured from surgery up to 120 hours.

Length of hospital stay was measured in hours

Secondary Outcome Measures
NameTimeMethod
Complication ratesPain was assessed after 6 hours postoperative; PONV, pruritus and urine retention were assessed for 24 hours; headache was assessed for 1 week; wound infection, puerperal sepsis and readmission were assessed up to 30 days postoperative

These included pain, PONV, headache, pruritus, urine retention, wound infection, puerperal sepsis and readmission

Trial Locations

Locations (1)

Mbarara university of Science and Technology

πŸ‡ΊπŸ‡¬

Mbarara, Uganda

Mbarara university of Science and Technology
πŸ‡ΊπŸ‡¬Mbarara, Uganda

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