Implementation of enhanced recovery in women undergoing cesarean delivery improves breastfeeding and maternal perioperative outcomes.

Abstract

The study aimed to evaluate delivery outcomes after implementation of the Enhanced Recovery After Surgery (ERAS) protocol in patients delivered by cesarean section (CD).This randomized controlled prospective study was conducted on 78 pregnant women who underwent CD with the ERAS protocol and 78 pregnant women who under went standard perioperative care. We compared the time to first flatus, visual pain score (VAS), the success of breastfeeding, time to initiation of breastfeeding, time to return to daily activities, hemoglobin values, the incidence of postoperative nausea and vomiting, hospital readmission rates, postoperative wound infection rates, incidence of postpartum blues, and the need for blood transfusion between two groups.Time to first flatus, VAS score, time to initiation of breastfeeding, and time to return to activities of daily living were significantly lower in the ERAS group (p<0.001 for all). The rate of successful breastfeeding was significantly higher in the ERAS group (p<0.001). Both groups were similar in terms of other parameters.Implementation of ERAS after CD shortens the breastfeeding initiation time and increases rates of successful breastfeeding. ERAS protocols implemented in CD improve perioperative outcomes such as visual pain score and time to resume daily activities.